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A practical guide for buprenorphine initiation in the primary care setting.
Roberto León-Barriera1, Samantha Jayne Zwiebel2, Vania Modesto-Lowe3
1Assistant Professor of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA ral187@pitt.edu.
Cleveland Clinic Journal of Medicine
|September 1, 2023
Summary
Buprenorphine is an effective opioid use disorder treatment, but initiation is challenging. Novel low-dose methods and updated prescribing practices can improve access and outcomes in primary care.
Area of Science:
- Pharmacology
- Addiction Medicine
- Primary Care
Background:
- Opioid use disorder (OUD) treatment with buprenorphine is underutilized.
- Conventional buprenorphine induction requires patients to be in opioid withdrawal, a significant barrier.
- Legal restrictions and unfamiliarity with buprenorphine's unique pharmacology have limited its adoption.
Approach:
- Review of legislative changes affecting buprenorphine prescribing.
- Analysis of physician perceptions and familiarity with buprenorphine.
- Examination of buprenorphine pharmacology and novel low-dose induction procedures.
Key Points:
- Buprenorphine is a safe and effective OUD treatment.
- Low-dose induction protocols can simplify buprenorphine initiation.
- Updated prescribing laws and improved physician understanding can increase buprenorphine accessibility.
Conclusions:
- Simplified buprenorphine induction in primary care can enhance treatment.
- Addressing barriers to buprenorphine initiation improves patient retention and outcomes.
- Buprenorphine holds significant potential for widespread OUD treatment.
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