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Buprenorphine diversion and misuse in outpatient practice
Michelle R Lofwall1, Judith Martin, Matt Tierney
1From the Departments of Behavioral Science and Psychiatry (MRL), Center on Drug and Alcohol Research, University of Kentucky College of Medicine, Lexington; Department of Public Health (JM), City and County of San Francisco, San Francisco, CA; Office-Based Buprenorphine Induction Clinic and Centralized Opiate Placement Evaluation Clinics (MT), Division of Substance Abuse and Addiction Medicine, Department of Psychiatry, San Francisco General Hospital, San Francisco, CA; Université de Bordeaux (Segalen) and Laboratoire de psychiatrie/SANPSY (MF, MA), CNRS USR 3413, Bordeaux, France, and Département d'Addictologie (MF, MA), CH Charles Perrens and CHU de Bordeaux, Bordeaux, France; Drug & Alcohol Services (NL), South East Sydney Local Health District, Caringbah, New South Wales, Australia; NSW Ministry of Health (NL), Sydney, New South Wales, Australia; and University of Sydney (NL), Darlington New South Wales, Australia.
This case study synthesizes real patient data to explore prescription opioid dependence treatment in outpatient settings. It highlights medication misuse and diversion, offering clinical insights for addiction medicine providers.
Area of Science:
- Addiction Medicine
- Pharmacology
- Clinical Psychology
Background:
- Prescription opioid dependence presents complex challenges in office-based treatment.
- Understanding medication diversion and misuse is critical for effective patient management.
Observation:
- A synthesized theoretical case illustrates common clinical scenarios of opioid misuse.
- Expert perspectives from international addiction specialists offer diverse insights.
Findings:
- The case demonstrates practical therapeutic responses to medication diversion and misuse.
- Successful treatment outcomes depend on proactive clinical strategies.
Implications:
- This case conference provides valuable guidance for clinicians treating opioid-dependent patients.
- Enhanced understanding of diversion and misuse can improve outpatient addiction treatment protocols.
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