Related Experiment Video
Updated: Jul 5, 2025
08:05
A Procedure to Study Stress-Induced Relapse of Heroin Seeking after Punishment-Imposed Abstinence
Published on: March 23, 2022
2.6K
Association between high-threshold practices and buprenorphine treatment termination
Valencia Lyle1, Samantha Harris2, Omeid Heidari3
1Bureau of Community and Health Systems, Michigan Department of Licensing and Regulatory Affairs, 611 W. Ottawa St, Lansing, MI 48909, USA.
The International Journal on Drug Policy
|January 17, 2024
Summary
High-threshold buprenorphine treatment practices, such as frequent drug testing and mandatory counseling, are associated with increased treatment termination rates for opioid use disorder. Minimizing these barriers is crucial for improving patient retention and addressing the overdose crisis.
Area of Science:
- Addiction Medicine
- Public Health Policy
- Pharmacotherapy
Background:
- Buprenorphine treatment for opioid use disorder (OUD) often includes frequent drug testing and counseling requirements.
- State policies frequently mandate these high-threshold practices, impacting treatment accessibility.
Purpose of the Study:
- To investigate the relationship between specific counseling and drug testing protocols and buprenorphine treatment discontinuation.
- To inform policy changes regarding OUD treatment standards in Michigan.
Main Methods:
- A survey was administered to 377 buprenorphine prescribers in Michigan.
- The survey collected data on prescriber practices regarding counseling and drug testing frequency.
Main Results:
- Prescribers requiring drug testing at every visit were 38% more likely to terminate treatment compared to those with less frequent or no testing.
- Prescribers mandating counseling showed a 33% higher likelihood of treatment termination than those without such requirements.
Conclusions:
- High-threshold practices in buprenorphine treatment, including frequent drug testing and mandatory counseling, are linked to increased treatment termination.
- Eliminating the DEA X-waiver necessitates policy adjustments to reduce these barriers and enhance treatment continuity for OUD.
Related Concept Videos
01:20Desensitization and Tachyphylaxis
1.7K
Tachyphylaxis is described as a rapid decrease in response to a drug after repeated or continuous administration of the same drug dose. It is a phenomenon where the body becomes less responsive to a particular substance or intervention over time, requiring higher doses or stronger interventions to achieve the same effect. It results from adaptive changes in the body's receptors, signaling pathways, or physiological processes that occur in response to prolonged exposure to a stimulus.
1.7K
01:15Drug Abuse and Addiction: Pharmacological Phenomena
476
Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not...
476
01:17Drug Dependence
1.0K
Medications are typically administered to achieve therapeutic effects. Some drugs can modify an individual's mood and perception, frequently resulting in various enjoyable experiences. However, this can result in drug dependency, a condition marked by continuous drug use despite potential negative consequences. Drug dependency primarily falls into two categories: psychological and physical dependence. Psychological dependence occurs when the pleasurable feelings induced by the drug...
1.0K
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
300
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
300
01:25Analgesia and Pain Management
625
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
625
01:22Drug Elimination by Renal Route: Tubular Reabsorption
3.4K
During the process of renal excretion, as the glomerular filtrate progresses to the distal convoluted tubule (DCT), drugs that are highly permeable, lipophilic, and nonionized undergo passive reabsorption from the tubular fluid into the surrounding peritubular capillaries. This reabsorption process restricts their elimination through the kidneys. However, the majority of drugs are either weak acids or weak bases, and their ionization level is dependent on pH. By altering the pH of urine, the...
3.4K