Pharmacological therapies for maintenance treatments of opium dependence

Rahimi-Movaghar, Afarin; Amin-Esmaeili, Ma­soumeh; Hefazi, Mitra; Yousefi‐Nooraie, Reza

doi:10.1002/14651858.cd007775.pub2

Cited by 18 publications

(14 citation statements)

References 55 publications

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“…However, few services provide agonist‐assisted detoxification and relapse prevention services. Despite the lack of evidence for superiority of opioid substitution treatment compared to detoxification and relapse prevention for treatment of opium dependence , since 2007 the Iranian Ministry of Health has discouraged drug treatment centres from using available agonists for detoxification. As a result, the main treatment currently available in these centres has been opioid substitution.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of illicit drug use disorders in Iran: prevalence, correlates, comorbidity and service utilization results from the Iranian Mental Health Survey

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Epidemiology of illicit drug use disorders in Iran: prevalence, correlates, comorbidity and service utilization results from the Iranian Mental Health Survey

et al. 2016

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“…Self-injection substitution is not good for abuse treatment, and over-dose always occurred following self-injection. Indeed, it seems that almost two thirds of patients show a sustained global improvement for at least two years [2] . Shortly after it was first commercialized, we started noticing that sublingual forms of Subutex were diverted through sniffing, inhaling, injecting, administration of high doses and primo-dependence cases.…”

Section: Introductionmentioning

confidence: 99%

Crushed and Injected Buprenorphine Tablets: Characteristics of Princeps and Generic Solutions

et al. 2014

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Self-injection of high-dose buprenorphine is responsible for well-described complications. In 2011, we have been alerted by unusual but serious cutaneous complication among injection buprenorphine users. A prospective data collection identified 30 cases of necrotic cutaneous lesions after injection of filtered buprenorphine solution, among which 25 cases occurred following injection of buprenorphine generics. The main goal of our study was to put forward particularities that could explain the cutaneous complications, by qualitatively and quantitatively confronting particles present in Subutex and generics solutions. We used the same protocol that injected-buprenorphine users: generic or subutex tablets were crushed in sterile water and filtered through 2 filters commonly used (cotton-pad and sterifilt). Solutions were analyzed by laser granulometry, flow cytometry and scanning electron microscopy. We have highlighted the wide variation of the quantity and the size of the particles present in solution between the two drugs after cotton-pad filtration. The proportion of particles <10 µm is systematically higher in the generic solutions than with Subutex. All of the insoluble particles found in generic solutions contain silica, whereas non- organic element was to be identified in the insoluble particles of Subutex. One skin biopsy obtained from one patient who developed a necrotic lesion after intravenous injection of filtrated solution of buprenorphine generic, shows non-organic elements. Identification of particles in situ enables us to confirm the presence of silica in the biopsy. Actually the monitoring of patient receiving generic of buprenorphine must be strengthened.

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“…Buprenorphine/naloxone combination is the most common agent used for maintenance treatment of opioid dependence in India (Rao, ). A meta‐analysis on pharmacologic therapies for maintenance treatment of “opium” dependence, by Rahimi‐Movaghar, Amin‐Esmaeili, Hefazi, and Yousefi‐Nooraie (), found insufficient data to make any specific treatment recommendations. However, they report that the use of buprenorphine as a substitution drug is the most preferred modality.…”

Section: Introductionmentioning

confidence: 99%

Buprenorphine/naloxone maintenance for “poppy husk” dependence: A retrospective study

Tikka

Singh

Mamidipalli

et al. 2019

Asia-Pacific Psychiatry

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Introduction: Despite a significant number of patients dependent on "poppy husk"in India, they are poorly characterized. Moreover, scarce data is available with respect to their treatment. Methods:A cohort of 148 patients with "poppy husk" dependence receiving substitution treatment with buprenorphine/naloxone were followed up for 4 years, using a retrospective chart-based assessment. Baseline demographic and substance-related characteristics were described. Retention rates (operationally redefined as "6 months of uninterrupted contact anytime during their visits") over the next 4 years and their predictors were assessed.Results: Mean age of onset of "poppy husk" use was found to be 27.51 years, and mean duration of dependence was 18.25 years. Mean amount of poppy husk consumed per month was 3.7 kg. Commonest reasons for initiating and quitting its use were enhancing work efficiency and lack of availability, respectively. Retention rates were 25%. Significant predictors of retention were age more than 40 years (OR = 2.295; 95%CI = 1. 015-5.19) and uninterrupted treatment duration for at least 1 month from first contact (for 1 month (OR = 5.625; 95%CI = 2.28-13.89), for 3 months (OR = 10.96; 95%CI = 4.65-25.85), and for 6 months (OR = 52.8; ). Discussion:Factors associated with occupation such as enhancing work efficiency and overcoming fatigue are related to use of "poppy husk." While the amount of intake is considerably large among treatment seekers who are dependent on it, their dependence duration is longer and retention rates lower than those reported for patients with prescription and injectable opioid dependence. Specific strategies to tap patients less than 40 years and to target uninterrupted contact in initial phases of maintenance should be developed.

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Pharmacological therapies for maintenance treatments of opium dependence

Cited by 18 publications

References 55 publications

Epidemiology of illicit drug use disorders in Iran: prevalence, correlates, comorbidity and service utilization results from the Iranian Mental Health Survey

Epidemiology of illicit drug use disorders in Iran: prevalence, correlates, comorbidity and service utilization results from the Iranian Mental Health Survey

Crushed and Injected Buprenorphine Tablets: Characteristics of Princeps and Generic Solutions

Buprenorphine/naloxone maintenance for “poppy husk” dependence: A retrospective study

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