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Keeping Up with Clinical Advances: Opioid Use Disorder

Published online by Cambridge University Press:  10 July 2019

Biren Patel
Affiliation:
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
Thomas R. Kosten*
Affiliation:
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA Michael E. DeBakey VA Medical Center, Houston, Texas, USA
*
*Address correspondence to: Thomas R Kosten MD, Waggoner Professor of Psychiatry, Pharmacology, Neuroscience and Immunology, 1977 Butler Blvd – Suite E4.207, Houston, TX 77030, USA. (Email: [email protected])

Abstract

Opioid use disorder (OUD) is a disorder that can lead to several negative outcomes, including overdose and death. A variety of opioids can be abused by individuals including both prescribed and non-prescribed opioids. Continued opioid use can be driven by negative affective states associated with opioid withdrawal. Several treatments exist in the field including medication assisted treatments such as methadone, buprenorphine, and naltrexone. Treatments such as clonidine and lofexidine can also be used to assist with decreasing withdrawal symptoms. Increasing adherence to treatment can further improve patient outcomes and promote continuation with treatment. A variety of methods to reduce relapse can also be utilized such as opioid agonists and maintenance therapy. According to the Centers for Disease Control, opioid overdoses contributed to 67.8% of overdose deaths in 2017.

Type
CME Review Article
Copyright
© Cambridge University Press 2019 

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Footnotes

This activity is supported by an unrestricted educational grant from Alkermes.

An addendum has been issued for this article, please see DOI: https://doi.org/10.1017/S1092852919001421.

References

REFERENCES:

McCance-Katz, EF. The National Survey on Drug Use and Health: 2017. In: NSDUH. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2017.Google Scholar
Centers for Disease Control and Prevention. Emergency Department Visits Involving Nonmedical Use of Selected Prescription Drugs. Morb Mortal Wkly Rep. 2010; 59(23): 705709.Google Scholar
Havens, JR, Walsh, S., Korthuis, P., et al. Implementing treatment of opioid use disorder in rural settings: A focus on HIV and Hepatitis C prevention and treatment. Curr HIV/AIDS. 2018; 15(4): 315323.CrossRefGoogle ScholarPubMed
Koo, DJ, Chitwood, DD, Sánchez, J. Factors for Employment: A Case-Control Study of Fully Employed and Unemployed Heroin Users. Subst Use Misuse. 2007; 42(7): 10351054.CrossRefGoogle ScholarPubMed
Volkow, ND, Jones, EB, Einstein, EB, et al. Prevention and Treatment of Opioid Misuse and Addiction: A Review. JAMA Psychiatry. 2019; 76(2): 208216.CrossRefGoogle ScholarPubMed
Scholl, L, Seth, P, Kariisa, M, et al. Drug and Opioid-Involved Overdose Deaths-United States, 20132017. MMWR. 2018; 67: 19.Google ScholarPubMed
U.S. Opioid Prescribing Rate Maps. Centers for Disease Control. https://www.cdc.gov/drugoverdose/maps/rxrate-maps.html. Published 2018. Accessed December 30, 2018.Google Scholar
Cicero, TJ, Ellis, MS, Surratt, HL, et al. The Changing Face of Heroin Use in the United States: A Retrospective Analysis of the Past 50 Years. JAMA Psychiatry. 2014; 71(7): 821826.CrossRefGoogle ScholarPubMed
Chumpitazi, CE, Rees, CA, Camp, EA, et al. Decreased Opioid Prescribing in a Pediatric Emergency Department After the Rescheduling of Hydrocodone. J Emerg Med. 2017; 52(4): 547553.CrossRefGoogle Scholar
Cicero, TJ, Kasper, ZA, Ellis, MS. Increased use of heroin as an initiating opioid of abuse: Further considerations and policy implications. Addict Behav. 2018; 87: 267271.CrossRefGoogle ScholarPubMed
Koob, GF, Volkow, ND. Neurocircuitry of Addiction. Neuropsychopharmacology. 2010; 35: 217238.CrossRefGoogle Scholar
Angst, MS, Clark, J. Opioid-induced Hyperalgesia: A Qualitative Systematic Review. Anesthesiology. 2006; 104(3): 570587.CrossRefGoogle ScholarPubMed
Stotts, AL, Dodrill, CL, Kosten, TR. Opioid Dependence Treatment: Options in Pharmacotherapy. Expert Opin Pharmacother. 2009; 10(11): 17271740.CrossRefGoogle ScholarPubMed
Coloma–Carmona, A, Carballo, JL, Rodríguez-Marín, J, et al. The Adjective Rating Scale for Withdrawal: Validation of its ability to assess severity of prescription opioid misuse. Eur J Pain. 2018; 23(2): 307315.CrossRefGoogle ScholarPubMed
Washton, AM. Outpatient Opiate Detoxification with Clonidine. J Clin Psychiatry. 1982; 43(6 II): 3941.Google ScholarPubMed
Kowalczyk, WJ, Phillips, KA, Jobes, ML, et al. Prolonging of Opioid Abstinence and Decoupling of Stress From Craving in Daily Life With Clonidine Maintenance Treatment: A Randomized Controlled Trial With Ecological Momentary Assessment. Am J Psychiatry. 2015; 172(8): 760767.CrossRefGoogle Scholar
Kosten, TR, O’Connor, P. Management of Drug and Alcohol Withdrawal. N Engl J Med. 2003; 348(18): 17861795.CrossRefGoogle ScholarPubMed
Galloway, GP, Koch, M, Cello, R, et al. Pharmacokinetics, safety, and tolerability of a depot formulation of naltrexone in alcoholics: an open-label trial. BMC Psychiatry. 2005; 5(18): 110.CrossRefGoogle ScholarPubMed
Brooks, AC, Comer, SD, Sullivan, MA, et al. Long-acting injectable versus oral naltrexone maintenance therapy with psychosocial intervention for heroin dependence: A quasi-experiment. J Clin Psychiatry. 2010; 71(10): 13711378.CrossRefGoogle ScholarPubMed
Krupitsky, E, Nunes, E V, Ling, W, et al. Injectable extended-release naltrexone for opioid dependence: a double-blind, placebo-controlled, multicentre randomised trial. Lancet. 2011; 377(9776): 15061513.CrossRefGoogle ScholarPubMed
Krupitsky, E. Injectable extended-release naltrexone (XR-NTX) for opioid dependence: long-term safety and effectiveness. Addiction. 2013; 108(9): 16281637.CrossRefGoogle ScholarPubMed
FDA. Naltrexone Extended Release Injectable Suspension: Medication Guide. Silver Spring, MD: Food and Drug Administration; 2010.Google Scholar
Dole, VP. On Federal Regulation of Methadone Treatment. JAMA J Am Med Assoc. 1995; 274(16): 1307.CrossRefGoogle ScholarPubMed
Substance Abuse and Mental Health Services Administration. National Survey of Substance Abuse Treatment Services (N-SSATS): 2017 Data on Substance Abuse Treatment Facilities. Vol BHSIS Seri.; 2017.Google Scholar
Senay, EC, Dorus, W, Goldberg, F, et al. Withdrawal From Methadone Maintenance. Arch Gen Psychiatry. 1977; 34: 361367.CrossRefGoogle ScholarPubMed
Mattick, R, Breen, C, Kimber, J, et al. Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence (Review). Cochrane Libr Syst Rev. 2014;CD002207(2).CrossRefGoogle Scholar
Kreek, MJ. Medical Safety and Side Effects of Methadone in Tolerant Individuals. JAMA J Am Med Assoc. 1973; 223(6): 665668.CrossRefGoogle ScholarPubMed
Benyamin, R, Trescot, AM, Datta, S, et al. Opioid complications and side effects. Pain Physician. 2008; 11(SPEC. ISS. 2):S105-S120.Google ScholarPubMed
Perrin-Terrin, A, Pathak, A, Lapeyre-Mestre, M. QT interval prolongation: prevalence, risk factors and pharmacovigilance data among methadone-treated patients in France. Fundam Clin Pharmacol. 2011; 25(4): 503510.CrossRefGoogle ScholarPubMed
Xi, X, Shorter, D, Kosten, T. Buprenorphine Prescribing: To Expand or Not to Expand. J Psychiatr Pract. 2016; 22(3): 183192.Google Scholar
Substance Abuse and Mental Health Services Administration. Buprenorphine Training for Physicians. SAMSHA. https://www.samhsa.gov/medication-assisted-treatment/training-resources/buprenorphine-physician-training. Published 2018. Accessed January 2, 2019.Google Scholar
Substance Abuse and Mental Health Services Administration. Apply to Increase Patient Limits. SAMSHA. https://www.samhsa.gov/medication-assisted-treatment/buprenorphine-waiver-management/increase-patient-limits. Published 2017. Accessed January 2, 2019.Google Scholar
FDA. Suboxone Medication Guide. Silver Spring, MD: Food and Drug Administration; 2018.Google Scholar
Dunn, KE, Saulsgiver, KA, Miller, ME, et al. Characterizing opioid withdrawal during double-blind buprenorphine detoxification. Drug Alcohol Depend. 2015; 151: 4755.CrossRefGoogle ScholarPubMed
Lutfy, K, Cowan, A. Buprenorphine: A Unique Drug with Complex Pharmacology. Curr Neuropharmacol. 2004; 2(4): 395402.CrossRefGoogle ScholarPubMed
Rosenblatt, RA, Andrilla, CH, Catlin, M, et al. Geographic and Specialty Distribution of US Physicians Trained to Treat Opioid Use Disorder. Ann Fam Med. 2015; 13(1): 2326.CrossRefGoogle ScholarPubMed
Jones, JD, Madera, G, Comer, SD. The Reinforcing and Subjective Effects of Intravenous and Intranasal Buprenorphine in Heroin Users. Pharmacol Biochem Behav. 2014; 122: 299306.CrossRefGoogle ScholarPubMed
Alho, H, Sinclair, D, Vuori, E, et al. Abuse liability of buprenorphine-naloxone tablets in untreated IV drug users. Drug Alcohol Depend. 2007; 88(1): 7578.CrossRefGoogle ScholarPubMed
Uosukainen, H, Kauhanen, J, Voutilainen, S, et al. Twelve-year trend in treatment seeking for buprenorphine abuse in Finland. Drug Alcohol Depend. 2013; 127(1–3): 207214.CrossRefGoogle ScholarPubMed
Genburg, BL, Gillespie, M, Schuster, CR, et al. Prevalance and Correlates of Street-Obtained Buprenorphine Use Among Current and Former Injectors in Baltimore, Maryland. Addict Behav. 2013; 38(12): 28682873.CrossRefGoogle Scholar
Dowell, D, Haegerich, TM , CR. CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016 Morbidity and Mortality Weekly Report. MMWR Recomm Reports. 2016; 65(1): 149.CrossRefGoogle Scholar
Adapt Pharma Inc. NARCAN (Naloxone Hydrochloride) Nasal Spray.; 2015.Google Scholar
New York State Department of Health. How to Use Injection Naloxone for Opioid Overdose.; 2015.Google Scholar
Zhou, Y, Leri, F. Neuroscience of Opiates for Addiction Medicine. Vol 223. 1st ed. Elsevier B.V.; 2015.Google ScholarPubMed
Bunce, SC, Harris, JD, Bixler, EO, et al. Possible evidence for re-regulation of HPA axis and brain reward systems over time in treatment in prescription opioid-dependent patients. J Addict Med. 2015; 9(1): 5360.CrossRefGoogle ScholarPubMed
Sinha, R, Kimmerling, A, Doebrick, C, et al. Effects of lofexidine on stress-induced and cue-induced opioid craving and opioid abstinence rates: Preliminary findings. Psychopharmacology (Berl). 2007; 190(4): 569574.CrossRefGoogle ScholarPubMed
Ball, JC, Ross, A. The Effectiveness of Methadone Maintenance Treatment. N Engl J Med. 1992; 326: 578.Google Scholar
Schwartz, RP, Kelly, SM, O’Grady, KE, et al. Interim methadone treatment compared to standard methadone treatment: 4-Month findings. J Subst Abuse Treat. 2011; 41(1): 2129.CrossRefGoogle ScholarPubMed
Dole, VP, Nyswander, M. A Medical Treatment for Diacetylmorphine (Heroin) Addiction. JAMA. 1965; 193(8): 646650.CrossRefGoogle ScholarPubMed
Fudala, PJ. Office-based treatment of opiate addiction with a sublingual-tablet formulation of buprenorphine and naloxone. N Engl J Med. 2003; 349(10): 949958.CrossRefGoogle ScholarPubMed
Atluri, S, Sudarshan, G, Manchikanti, L. Assessment of the trends in medical use and misuse of opioid analgesics from 2004 to 2011. Pain Physician. 2014; 17(2):E119-E128.Google ScholarPubMed
Spire, B, Cohen, J, Michel, L, et al. Predictors of Non-Adherence to Methadone Maintenance Treatment in Opioid-Dependent Individuals: Implications for Clinicians. Curr Pharm Des. 2014; 20(25): 40974105.Google Scholar
Caroline, L, Patrizia, CM, Laurent, M, et al. Predictors of non-prescribed opioid use after one year of methadone treatment: an attributable-risk approach (ANRS-Methaville trial). Drug Alcohol Depend. 2014; 135: 18.Google Scholar
Johnson, RE, Fudala, PJ, Jaffe, JH. A Controlled Trial of Buprenorphine Treatment for Opioid Dependence. J Am Med Assoc. 1992; 267(20): 27502755.CrossRefGoogle ScholarPubMed
Strand, MC, Vindenes, V, Gjerde, H, Mørland, JG, Ramaekers, JG. A clinical trial on the acute effects of methadone and buprenorphine on actual driving and cognitive function of healthy volunteers. Br J Clin Pharmacol. 2019; 85(2): 442453.CrossRefGoogle ScholarPubMed
Larochelle, M.R, Bernson, D, Land, T, Stopka, T.J, Wang, N. Medication for Opioid Use Disorder After Nonfatal Opioid Overdose and Association with Mortality: A Cohort Study. Ann Intern Med. 2018; 169(3): 137145.CrossRefGoogle ScholarPubMed
Sordo, L, Barrio, G, Bravo, MJ, et al. Mortality risk during and after opioid substitution treatment: systematic review and meta-analysis of cohort studies. BMJ. 2017; 357: 15501550.CrossRefGoogle ScholarPubMed
Suzuki, J, El-Haddad, S. A review: Fentanyl and non-pharmaceutical fentanyls. Drug Alcohol Depend. 2017; 171: 107116.CrossRefGoogle ScholarPubMed