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Soyka M. New developments in the management of opioid dependence: focus on sublingual buprenorphine-naloxone. Subst Abuse Rehabil. 2015;6:1-14doi: 10.2147/SAR.S45585.
Soyka, M. (2015). New developments in the management of opioid dependence: focus on sublingual buprenorphine-naloxone. Substance abuse and rehabilitation, 61-14. https://doi.org/10.2147/SAR.S45585
Soyka, Michael. "New developments in the management of opioid dependence: focus on sublingual buprenorphine-naloxone." Substance abuse and rehabilitation vol. 6 (2015): 1-14. doi: https://doi.org/10.2147/SAR.S45585
Soyka M. New developments in the management of opioid dependence: focus on sublingual buprenorphine-naloxone. Subst Abuse Rehabil. 2015 Jan 06;6:1-14. doi: 10.2147/SAR.S45585. eCollection 2015. PMID: 25610012; PMCID: PMC4293937.
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Subst Abuse Rehabil. 2015 Jan 06;6:1-14. doi: 10.2147/SAR.S45585. eCollection 2015.

New developments in the management of opioid dependence: focus on sublingual buprenorphine-naloxone.

Substance abuse and rehabilitation

Michael Soyka

Affiliations

  1. Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany ; Private Hospital Meiringen, Meiringen, Switzerland.

PMID: 25610012 PMCID: PMC4293937 DOI: 10.2147/SAR.S45585

Abstract

Opioid maintenance therapy is a well-established first-line treatment approach in opioid dependence. Buprenorphine, a partial opioid agonist, has been found by numerous studies to be an effective and safe medication in the treatment of opioid dependence. At present, buprenorphine is available as a monodrug or in a fixed 4:1 ratio combination with naloxone. A diminished risk of diversion and abuse for the buprenorphine-naloxone combination is likely but not firmly established. Conventional formulations are given sublingually to avoid the hepatic first-pass effect. A novel film tablet is available only in the US and Australia. Other novel, sustained-release formulations (implant, depot) are currently being developed and tested. Recent studies, including a Cochrane meta-analysis, suggest that the retention with buprenorphine is lower than for methadone, but that buprenorphine may be associated with less drug use. Higher doses of buprenorphine are associated with better retention rates. Buprenorphine has a ceiling effect at the opioid receptor with regard to respiratory depression, and may cause fewer fatal intoxications than methadone. Possible antidepressant effects of buprenorphine and its use in comorbid psychiatric patients has not been studied in much detail. Clinical implications are discussed.

Keywords: buprenorphine; methadone; naloxone; opioid dependence; opioids; therapy

References

  1. Acta Clin Belg. 1999;53 Suppl 1:29-31 - PubMed
  2. J Subst Abuse Treat. 2000 Apr;18(3):277-81 - PubMed
  3. Am J Addict. 2000 Summer;9(3):265-9 - PubMed
  4. Drug Alcohol Depend. 2000 Dec 22;61(1):85-94 - PubMed
  5. JAMA. 2001 Jan 3;285(1):45 - PubMed
  6. Drug Alcohol Depend. 2001 Feb 1;61(3):271-80 - PubMed
  7. J Hepatol. 2001 Feb;34(2):261-9 - PubMed
  8. J Hepatol. 2001 Feb;34(2):346-50 - PubMed
  9. Psychopharmacology (Berl). 2001 Mar;154(3):230-42 - PubMed
  10. Forensic Sci Int. 2001 Sep 15;121(1-2):65-9 - PubMed
  11. Biol Pharm Bull. 2002 May;25(5):682-5 - PubMed
  12. Anal Biochem. 2002 Jul 1;306(1):31-9 - PubMed
  13. Clin J Pain. 2002 Jul-Aug;18(4 Suppl):S14-27 - PubMed
  14. Clin Biochem. 2002 Oct;35(7):513-6 - PubMed
  15. Drug Alcohol Depend. 2003 May 21;70(2 Suppl):S39-47 - PubMed
  16. Drug Metab Dispos. 2003 Jun;31(6):768-72 - PubMed
  17. Acta Anaesthesiol Scand. 2003 Sep;47(8):1031-3 - PubMed
  18. Arch Gen Psychiatry. 2003 Oct;60(10):993-1000 - PubMed
  19. Psychopharmacology (Berl). 2004 Apr;172(4):463-70 - PubMed
  20. Arch Gen Psychiatry. 2004 Feb;61(2):152-9 - PubMed
  21. Eur Neuropsychopharmacol. 2004 May;14(3):209-16 - PubMed
  22. Clin Pharmacokinet. 2004;43(5):329-40 - PubMed
  23. Drug Alcohol Depend. 2004 Jul 15;75(1):37-45 - PubMed
  24. Addiction. 2004 Aug;99(8):978-88 - PubMed
  25. Eur J Gastroenterol Hepatol. 2004 Oct;16(10):1033-7 - PubMed
  26. Eur J Clin Pharmacol. 2005 Feb;60(12):875-81 - PubMed
  27. Am J Psychiatry. 2005 Feb;162(2):340-9 - PubMed
  28. Biol Pharm Bull. 2005 Feb;28(2):212-6 - PubMed
  29. Drug Metab Dispos. 2005 May;33(5):689-95 - PubMed
  30. Drug Alcohol Depend. 2005 May 9;78(2):225-30 - PubMed
  31. Pharmacotherapy. 2005 Apr;25(4):611-4 - PubMed
  32. Brain Res. 2005 Aug 9;1052(2):222-31 - PubMed
  33. Drug Alcohol Rev. 2005 Sep;24(5):411-8 - PubMed
  34. Prog Neuropsychopharmacol Biol Psychiatry. 2006 Mar;30(2):265-72 - PubMed
  35. J Subst Abuse Treat. 2005 Dec;29(4):307-12 - PubMed
  36. Drug Metab Dispos. 2006 Mar;34(3):440-8 - PubMed
  37. J Clin Psychopharmacol. 2006 Dec;26(6):657-60 - PubMed
  38. Expert Opin Drug Saf. 2007 Mar;6(2):125-32 - PubMed
  39. Drug Saf. 2007;30(4):277-94 - PubMed
  40. Am J Psychiatry. 2007 May;164(5):797-803 - PubMed
  41. Clin Neuropharmacol. 2007 May-Jun;30(3):127-35 - PubMed
  42. Am J Psychiatry. 2007 Apr;164(4 Suppl):5-123 - PubMed
  43. Drug Alcohol Depend. 2007 Dec 1;91(2-3):187-94 - PubMed
  44. Am J Drug Alcohol Abuse. 2007;33(6):869-74 - PubMed
  45. Arch Intern Med. 2007 Dec 10;167(22):2469-75 - PubMed
  46. Drug Alcohol Depend. 2008 Apr 1;94(1-3):125-32 - PubMed
  47. Addiction. 2008 Mar;103(3):462-8 - PubMed
  48. Am J Psychiatry. 2008 Feb;165(2):179-87 - PubMed
  49. Int J Neuropsychopharmacol. 2008 Aug;11(5):641-53 - PubMed
  50. BMC Psychiatry. 2008 Feb 13;8:8 - PubMed
  51. Drug Alcohol Depend. 2008 Jun 1;95(3):245-57 - PubMed
  52. Toxicol Sci. 2008 Nov;106(1):64-73 - PubMed
  53. Am J Emerg Med. 2008 Sep;26(7):840.e3-5 - PubMed
  54. Lancet. 2008 Nov 15;372(9651):1733-45 - PubMed
  55. Psychiatry Res. 2009 Mar 31;166(1):7-14 - PubMed
  56. Drugs. 2009;69(5):577-607 - PubMed
  57. Ann Pharmacother. 2009 May;43(5):973-7 - PubMed
  58. Drug Alcohol Depend. 2009 Sep 1;104(1-2):73-7 - PubMed
  59. Basic Clin Pharmacol Toxicol. 2009 Sep;105(3):211-5 - PubMed
  60. Addiction. 2009 Jul;104(7):1193-200 - PubMed
  61. Cochrane Database Syst Rev. 2009 Jul 08;(3):CD002209 - PubMed
  62. Drug Metab Lett. 2009 Apr;3(2):101-7 - PubMed
  63. Drug Alcohol Depend. 2009 Nov 1;105(1-2):9-15 - PubMed
  64. Expert Opin Pharmacother. 2009 Oct;10(15):2537-44 - PubMed
  65. Drug Alcohol Depend. 2009 Dec 1;105(3):234-9 - PubMed
  66. Drug Metab Dispos. 2010 Jan;38(1):40-5 - PubMed
  67. Drug Alcohol Depend. 2010 Mar 1;107(2-3):141-8 - PubMed
  68. Am J Addict. 2010 Jan-Feb;19(1):17-29 - PubMed
  69. Am J Addict. 2010 Jan-Feb;19(1):30-7 - PubMed
  70. Am J Addict. 2010 Jan-Feb;19(1):59-72 - PubMed
  71. J Interv Card Electrophysiol. 2010 Jun;28(1):19-22 - PubMed
  72. J Subst Abuse Treat. 2010 Jun;38 Suppl 1:S53-60 - PubMed
  73. Psychopharmacology (Berl). 2010 Jun;210(2):121-35 - PubMed
  74. Curr HIV/AIDS Rep. 2010 Aug;7(3):152-60 - PubMed
  75. J Acquir Immune Defic Syndr. 2010 Aug;54(5):511-4 - PubMed
  76. Am J Prev Med. 2010 Oct;39(4):357-63 - PubMed
  77. Life Sci. 2011 May 23;88(21-22):953-8 - PubMed
  78. Forensic Sci Int. 2011 Apr 15;207(1-3):170-6 - PubMed
  79. Addiction. 2011 Jan;106(1):32-51 - PubMed
  80. N Engl J Med. 2010 Nov 18;363(21):1981-5 - PubMed
  81. J Addict Med. 2010 Dec;4(4):211-6 - PubMed
  82. Eur Addict Res. 2011;17(2):80-9 - PubMed
  83. Am J Drug Alcohol Abuse. 2011 Jan;37(1):1-11 - PubMed
  84. Clin Pharmacol Ther. 2011 Mar;89(3):443-9 - PubMed
  85. J Acquir Immune Defic Syndr. 2011 Mar 1;56 Suppl 1:S62-7 - PubMed
  86. Drug Alcohol Depend. 2011 Sep 1;117(2-3):85-101 - PubMed
  87. Addiction. 2011 Aug;106(8):1460-73 - PubMed
  88. Curr Drug Abuse Rev. 2011 Mar;4(1):28-41 - PubMed
  89. World J Biol Psychiatry. 2011 Apr;12(3):160-87 - PubMed
  90. Drug Alcohol Depend. 2011 Nov 1;118(2-3):479-83 - PubMed
  91. Clin Pharmacol Ther. 2011 Jun;89(6):806-15 - PubMed
  92. Drug Alcohol Depend. 2011 Nov 1;118(2-3):326-34 - PubMed
  93. Addiction. 2012 Jan;107(1):142-51 - PubMed
  94. J Clin Psychopharmacol. 2011 Oct;31(5):678-80 - PubMed
  95. Eur J Clin Pharmacol. 2012 Mar;68(3):301-9 - PubMed
  96. Cochrane Database Syst Rev. 2011 Oct 05;(10):CD004147 - PubMed
  97. J Addict Med. 2011 Dec;5(4):254-63 - PubMed
  98. Clin Infect Dis. 2012 Feb 1;54(3):414-23 - PubMed
  99. Arch Gen Psychiatry. 2012 Apr;69(4):372-80 - PubMed
  100. Br J Clin Pharmacol. 2012 Nov;74(5):835-41 - PubMed
  101. Antimicrob Agents Chemother. 2012 Jul;56(7):3641-7 - PubMed
  102. J Psychopharmacol. 2012 Jul;26(7):899-952 - PubMed
  103. Drug Alcohol Depend. 2013 Jan 1;127(1-3):243-7 - PubMed
  104. Drug Alcohol Depend. 2013 Feb 1;128(1-2):71-6 - PubMed
  105. Crit Care Med. 2012 Dec;40(12):3215-23 - PubMed
  106. Expert Opin Drug Deliv. 2012 Nov;9(11):1409-17 - PubMed
  107. Addiction. 2012 Nov;107 Suppl 1:91-7 - PubMed
  108. Drug Alcohol Depend. 1990 Feb;25(1):27-34 - PubMed
  109. MMWR Morb Mortal Wkly Rep. 2012 Dec 14;61(49):997-1001 - PubMed
  110. Traffic Inj Prev. 2013;14(1):26-38 - PubMed
  111. Am J Med. 2013 Jan;126(1):74.e11-7 - PubMed
  112. Pharmacopsychiatry. 2013 May;46(3):94-107 - PubMed
  113. Drug Alcohol Depend. 2013 Jul 1;131(1-2):119-26 - PubMed
  114. Am J Drug Alcohol Abuse. 2013 Mar;39(2):80-5 - PubMed
  115. Expert Opin Drug Metab Toxicol. 2013 Jun;9(6):675-97 - PubMed
  116. Neuropsychopharmacology. 2013 Sep;38(10):2003-10 - PubMed
  117. Addiction. 2013 Oct;108(10):1788-98 - PubMed
  118. Euro Surveill. 2013 May 30;18(22):null - PubMed
  119. Addiction. 2014 Jan;109(1):79-87 - PubMed
  120. J Pediatr. 2013 Nov;163(5):1377-83.e1-3 - PubMed
  121. Lancet. 2013 Nov 9;382(9904):1564-74 - PubMed
  122. Pharmacogenomics J. 2014 Jun;14(3):303-8 - PubMed
  123. Fortschr Neurol Psychiatr. 2013 Nov;81(11):648-54 - PubMed
  124. Am J Addict. 2014 Jan-Feb;23(1):62-7 - PubMed
  125. Drug Alcohol Depend. 2014 Mar 1;136:21-7 - PubMed
  126. NIDA Res Monogr. 1987;76:145-9 - PubMed
  127. Cochrane Database Syst Rev. 2014 Feb 06;(2):CD002207 - PubMed
  128. Psychopharmacology (Berl). 1988;94(4):484-90 - PubMed
  129. Int J Neuropsychopharmacol. 2014 Sep;17(9):1367-73 - PubMed
  130. Addiction. 2014 Aug;109(8):1320-33 - PubMed
  131. Toxicol Lett. 2014 Jul 15;228(2):75-84 - PubMed
  132. Drug Alcohol Depend. 2014 Sep 1;142:139-45 - PubMed
  133. Clin Pharmacokinet. 2014 Sep;53(9):813-24 - PubMed
  134. Addict Biol. 2015 Jul;20(4):784-98 - PubMed
  135. Exp Clin Psychopharmacol. 2014 Oct;22(5):424-33 - PubMed
  136. JAMA Intern Med. 2014 Aug;174(8):1369-76 - PubMed
  137. Drug Alcohol Depend. 2014 Nov 1;144:1-11 - PubMed
  138. Am J Addict. 2014 Nov-Dec;23(6):563-9 - PubMed
  139. Addiction. 2015 Jun;110(6):891-8 - PubMed
  140. Am J Psychiatry. 1987 Oct;144(10):1340-2 - PubMed
  141. Lancet. 1982 Sep 25;2(8300):709 - PubMed
  142. Arch Gen Psychiatry. 1982 Feb;39(2):151-6 - PubMed
  143. J Clin Psychopharmacol. 1995 Feb;15(1):49-57 - PubMed
  144. Clin Pharmacol Ther. 1994 May;55(5):569-80 - PubMed
  145. Arch Gen Psychiatry. 1993 Jul;50(7):577-84 - PubMed
  146. Arch Gen Psychiatry. 1996 May;53(5):401-7 - PubMed
  147. J Anal Toxicol. 1996 Oct;20(6):369-78 - PubMed
  148. Arch Gen Psychiatry. 1997 Jan;54(1):71-80 - PubMed
  149. Arch Gen Psychiatry. 1997 Aug;54(8):713-20 - PubMed
  150. Drug Alcohol Depend. 1997 Nov 25;48(2):135-41 - PubMed
  151. Drug Metab Dispos. 1998 Aug;26(8):818-21 - PubMed
  152. Addict Behav. 1998 Nov-Dec;23(6):893-907 - PubMed

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