Narrative Review: Buprenorphine for Opioid-Dependent Patients in Office Practice

Ann Intern Med. 2008 May 6;148(9):662-70. doi: 10.7326/0003-4819-148-9-200805060-00006.

Abstract

The profile of opioid dependence in the United States is changing. Abuse of prescription opioids is more common than that of illicit opioids: Recent data indicate that approximately 1.6 million persons abuse or are dependent on prescription opioids, whereas 323,000 abuse or are dependent on heroin. Despite this prevalence, nearly 80% of opioid-dependent persons remain untreated. One option for expanding treatment is the use of buprenorphine and the buprenorphine-naloxone combination. Buprenorphine is a partial opioid agonist that can be prescribed by trained physicians and dispensed at pharmacies. This article addresses the clinical presentation of a patient with opioid dependence and describes the relatively new practice of office-based treatment with buprenorphine-naloxone. The different components of treatment; the role of the physician who provides this treatment; and the logistics of treating this growing, multifaceted patient population are also examined.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Buprenorphine / therapeutic use*
  • Drug Combinations
  • Female
  • Humans
  • Methadone / therapeutic use
  • Naloxone / therapeutic use*
  • Narcotic Antagonists / therapeutic use*
  • Narcotics / therapeutic use
  • Opioid-Related Disorders / diagnosis
  • Opioid-Related Disorders / drug therapy*
  • Patient Care Planning / standards*
  • Physician's Role*
  • Primary Health Care / standards

Substances

  • Drug Combinations
  • Narcotic Antagonists
  • Narcotics
  • Naloxone
  • Buprenorphine
  • Methadone