The importance of buprenorphine research in the opioid crisis

Pendergrass, Sarah A.; Crist, Richard C.; Jones, Laney K.; Hoch, Jason R; Berrettini, Wade H.

doi:10.1038/s41380-018-0329-5

Cited by 13 publications

(13 citation statements)

References 56 publications

(59 reference statements)

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“…Buprenorphine is a μ-opioid receptor partial agonist and κ-opioid receptor antagonist that is commonly used to treat opioid use disorder. It also exerts antidepressant and anxiolytic activity and is a promising treatment for neonatal opioid withdrawal syndrome 110 . A retrospective cohort study showed that 6-month treatment retention rates and opioid abstinence rates were not different between individuals who were positive for fentanyl or heroin at baseline before initiating buprenorphine treatment, indicating that buprenorphine may still be beneficial for treating fentanyl exposure 111 .…”

Section: Interventions For the Management And Prevention Of Fentanyl mentioning

confidence: 99%

The rising crisis of illicit fentanyl use, overdose, and potential therapeutic strategies

et al. 2019

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Fentanyl is a powerful opioid anesthetic and analgesic, the use of which has caused an increasing public health threat in the United States and elsewhere. Fentanyl was initially approved and used for the treatment of moderate to severe pain, especially cancer pain. However, recent years have seen a growing concern that fentanyl and its analogs are widely synthesized in laboratories and adulterated with illicit supplies of heroin, cocaine, methamphetamine, and counterfeit pills, contributing to the exponential growth in the number of drug-related overdose deaths. This review summarizes the recent epidemic and evolution of illicit fentanyl use, its pharmacological mechanisms and side effects, and the potential clinical management and prevention of fentanyl-related overdoses. Because social, economic, and health problems that are related to the use of fentanyl and its analogs are growing, there is an urgent need to implement large-scale safe and effective harm reduction strategies to prevent fentanyl-related overdoses.

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Section: Interventions For the Management And Prevention Of Fentanyl mentioning

confidence: 99%

The rising crisis of illicit fentanyl use, overdose, and potential therapeutic strategies

et al. 2019

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“…There are some authors of scientific publications claiming that an adequate opioid blockade requires an 'optimal exposure' with BUP plasma concentrations of 2-3 ng/ mL and that this is achieved with a daily sublingual (SL) dose of BUP or buprenorphine/naloxone (BUP-NLX) of 16 mg and higher [5][6][7]. However, others suggest that further research is needed to understand dose-response relationships in patients with this complex disorder [8,9].…”

Section: Introductionmentioning

confidence: 99%

Optimal dose of buprenorphine in opioid use disorder treatment: a review of pharmacodynamic and efficacy data

Hjelmström¹,

Nordbeck²,

Tiberg³

2020

Drug Development and Industrial Pharmacy

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Context: There is currently no consensus regarding optimal dose or dose-range of buprenorphine (BUP) for treatment of opioid use disorder (OUD). Objective: To elucidate the relationship between BUP dose and opioid receptor blockade, retention in treatment and illicit opioid drug use. Methods: Systematic review of the scientific literature through searches in the databases MEDLINE and PubMed. Results: The review of the opioid receptor blockade studies did not find evidence that a daily sublingual (SL) BUP tablet dose higher than 16 mg confers added blockade benefit, while doses under 8 mg are insufficient to produce opioid receptor blockade. The data are inconclusive regarding the relative effectiveness of an 8 mg SL BUP tablet dose versus a 16 mg SL BUP tablet dose in terms of opioid receptor blockade. The review did not establish any clear relationship between BUP dose and treatment retention or illicit opioid use. Conclusions: The BUP dose in treatment of OUD should be individualized based on a continuous clinical benefit-risk assessment. Further research is needed to better understand the relationship between dose and efficacy over time in patients with this complex disorder.

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“…Buprenorphine is a commonly used opiate agonist treatment (OAT) 14 . It is a partial agonist of the μ, and a full antagonist of the κ, opioid receptor 15,16 .…”

Section: Introductionmentioning

confidence: 99%

Treatment with buprenorphine prior to EcoHIV infection of mice prevents the development of neurocognitive impairment

Jaureguiberry‐Bravo

Kelschenbach

Murphy

et al. 2020

Journal of Leukocyte Biology

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Approximately 15–40% of people living with HIV develop HIV‐associated neurocognitive disorders, HAND, despite successful antiretroviral therapy. There are no therapies to treat these disorders. HIV enters the CNS early after infection, in part by transmigration of infected monocytes. Currently, there is a major opioid epidemic in the United States. Opioid use disorder in the context of HIV infection is important because studies show that opioids exacerbate HIV‐mediated neuroinflammation that may contribute to more severe cognitive deficits. Buprenorphine is an opioid derivate commonly prescribed for opiate agonist treatment. We used the EcoHIV mouse model to study the effects of buprenorphine on cognitive impairment and to correlate these with monocyte migration into the CNS. We show that buprenorphine treatment prior to mouse EcoHIV infection prevents the development of cognitive impairment, in part, by decreased accumulation of monocytes in the brain. We propose that buprenorphine has a novel therapeutic benefit of limiting the development of neurocognitive impairment in HIV‐infected opioid abusers as well as in nonabusers, in addition to decreasing the use of harmful opioids. Buprenorphine may also be used in combination with HIV prevention strategies such as pre‐exposure prophylaxis because of its safety profile.

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The importance of buprenorphine research in the opioid crisis

Cited by 13 publications

References 56 publications

The rising crisis of illicit fentanyl use, overdose, and potential therapeutic strategies

The rising crisis of illicit fentanyl use, overdose, and potential therapeutic strategies

Optimal dose of buprenorphine in opioid use disorder treatment: a review of pharmacodynamic and efficacy data

Treatment with buprenorphine prior to EcoHIV infection of mice prevents the development of neurocognitive impairment

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