Rapid Micro-induction of Buprenorphine/Naloxone for Opioid Use Disorder in a Critically ill Intubated Patient: A Case Report.

Abstract:

BACKGROUND:Buprenorphine/naloxone has been shown to be an effective treatment of opioid use disorder. According to the Canadian National clinical practice guideline on the management of opioid use disorders, given the superior safety profile of buprenorphine/naloxone and its potential for flexible take-home dosing in comparison to other opioid agonist medication it is strongly recommended to initiate opioid agonist treatment with buprenorphine/naloxone as the preferred first-line treatment when possible. Due to its pharmacological properties induction can be challenging, requiring the cessation of all opioids for a certain amount of time to avoid the risk of precipitated withdrawal symptoms. For this reason, buprenorphine/naloxone is not initiated for the treatment of opioid use disorder in critically ill patients where continuous infusion of opioids are required for maintenance of sedation resulting in a missed opportunity for first line treatment of that patient's opioid use disorder. CASE SUMMARY:We present a case of a 29-year-old female with opioid use disorder admitted for infective endocarditis and septic shock requiring intubation for hypoxic respiratory failure secondary to bilateral lung septic emboli with a high opioid debt requiring higher than typical doses of fentanyl and dexmedetomidine infusions to maintain sedation with clinical objective sign of inadequate treatment of her pain and opioid withdrawal. She was successfully started on buprenorphine/naloxone using a rapid micro-induction technique that did not cause precipitated withdrawal or require cessation of her fentanyl infusion. CONCLUSION:This case illustrates a new method for starting buprenorphine/naloxone in a critically ill intubated patient, where buprenorphine/naloxone was never a consideration in this specific patient population. SCIENTIFIC SIGNIFICANCE:This method can be used to minimize barriers to opioid agonist therapy in intubated patients.

journal_name

J Addict Med

authors

Hamata B,Griesdale D,Hann J,Rezazadeh-Azar P

doi

10.1097/ADM.0000000000000675

subject

Has Abstract

pub_date

2020-12-01 00:00:00

pages

514-517

issue

6

eissn

1932-0620

issn

1935-3227

pii

01271255-202012000-00034

journal_volume

14

pub_type

杂志文章
  • Changes in regional cerebral blood flow are associated with endothelial dysfunction markers in cocaine-dependent patients under recent abstinence.

    abstract:OBJECTIVES:Cocaine is a known risk factor for several vascular ischemic events. The underlying mechanisms leading to the complications are not fully understood, although thrombus formation and accelerated atherosclerosis are prominent findings. Evidence of endothelial dysfunction (ED), a key phenomenon in the pathogene...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0000000000000109

    authors: Massardo T,Quintana JC,Jaimovich R,Sáez CG,Cabreras MJ,Pereira-Flores K,Ibáñez C,Pallavicini J,Véliz J,Mezzano D,Pereira J

    更新日期:2015-03-01 00:00:00

  • Utilization of evidence-based smoking cessation treatments by psychiatric inpatient smokers with depression.

    abstract:OBJECTIVES:Although smoking is a major health issue among depressed psychiatric inpatients and interest in quitting is high, successful quit rates remain low among this population. We sought to understand preferences that depressed inpatient smokers may have for cessation treatments. METHODS:Eighty smokers (60% women,...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0000000000000027

    authors: Strong DR,Uebelacker L,Fokas K,Saritelli J,Matsko S,Abrantes AM,Schonbrun Y

    更新日期:2014-03-01 00:00:00

  • Income differences and recreational gambling.

    abstract::The purpose of this study was to examine the correlates of recreational gambling in lower-income compared with middle/higher-income groups. We examined, by logistic regression, a nationally representative U.S. adult sample (n = 2417) from the 1998 Gambling Impact and Behavior Study (GIBS) to investigate the influence ...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0b013e318125088f

    authors: Barry DT,Maciejewski PK,Desai RA,Potenza MN

    更新日期:2007-09-01 00:00:00

  • Development and implementation of an opioid overdose prevention program within a preexisting substance use disorders treatment center.

    abstract::This case study of the development and implementation of an opioid overdose prevention program is based on an actual clinic's experience, but information about the clinic, including details of implementation and outcome measures, has been changed. Four experts reflect on the medical, administrative, peer-support, comm...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0000000000000032

    authors: Wilder CM,Brason FW 2nd,Clark AK,Galanter M,Walley AY,Winstanley EL

    更新日期:2014-05-01 00:00:00

  • Associations of functional and dysfunctional impulsivity to smoking characteristics.

    abstract:OBJECTIVES:Although the relation between impulsivity and smoking is well-documented, one model of impulsivity that has received little attention in the addiction literature separates impulsivity into 2 dimensions: functional impulsivity (tendency to make quick effective decisions) and dysfunctional impulsivity (tendenc...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0b013e31825e2a67

    authors: Pitts SR,Leventhal AM

    更新日期:2012-09-01 00:00:00

  • Co-occurring Substance Use Disorders in Youth With Chronic Medical Conditions: The Need for Integration of Addiction Treatment into Mainstream Medical Facilities.

    abstract::: Approximately 5% of adolescents in the US meet criteria for a substance use disorder (SUD), and many of them benefit from residential treatment programs at points in the course of the disorder to achieve early sobriety and stabilization. Youth with chronic medical conditions use alcohol, marijuana, and other substan...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0000000000000557

    authors: Chadi N,Schizer M,Mountain-Ray S,Thakur A,Weitzman ER,Levy S

    更新日期:2020-05-01 00:00:00

  • HIV-risk characteristics in community corrections.

    abstract:OBJECTIVE:Individuals in the criminal justice system engage in behaviors that put them at high risk for HIV. This study sought to identify characteristics of individuals who are under community corrections supervision (eg, probation) and at risk for HIV. METHODS:Approximately 25,000 individuals under community correct...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0b013e3182781806

    authors: Clark CB,McCullumsmith CB,Waesche MC,Islam MA,Francis R,Cropsey KL

    更新日期:2013-01-01 00:00:00

  • Factors Associated With Use of ASAM Criteria and Service Provision in a National Sample of Outpatient Substance Abuse Treatment Units.

    abstract::Standardized patient placement criteria such as those developed by the American Society of Addiction Medicine are increasingly common in substance abuse treatment, but it is unclear what factors are associated with their use or with treatment units' provision of related services. This study examined these issues in th...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0b013e31818ebb6f

    authors: Chuang E,Wells R,Alexander JA,Friedmann PD,Lee IH

    更新日期:2009-09-01 00:00:00

  • PET imaging of dopamine D2 receptor and transporter availability during acquisition of cocaine self-administration in rhesus monkeys.

    abstract::Previous studies have demonstrated that cocaine use alters availability of brain dopamine D2 receptors (D2R) and transporters (DAT). The present study examined the effects of low doses of cocaine on this neuroadaptation. Using positron emission tomography (PET), D2R and DAT availability in the caudate nucleus (Cd), pu...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0b013e318045c038

    authors: Czoty PW,Gage HD,Nader SH,Reboussin BA,Bounds M,Nader MA

    更新日期:2007-03-01 00:00:00

  • Facilitating factors and barriers to the use of medications in publicly funded addiction treatment organizations.

    abstract:OBJECTIVES:Publicly funded addiction treatment organizations have been slow to adopt pharmacotherapies. Few studies have examined the organizational factors associated with adoption of different types of medication in this treatment sector. This study identifies organization-level facilitators and barriers to the use o...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0b013e3181b41a32

    authors: Knudsen HK,Roman PM,Oser CB

    更新日期:2010-06-01 00:00:00

  • Counselors' Experiences Treating Methadone-maintained Patients with Chronic Pain: A Needs Assessment Study.

    abstract:PURPOSE:: This study was designed to conduct a needs assessment concerning methadone counselors' experiences working with methadone-maintained patients with chronic pain and measure counselors' interest in receiving specialized training to treat such patients. METHODS:: A survey, developed by the authors, was administ...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0b013e31815ec240

    authors: Barry DT,Bernard MJ,Beitel M,Moore BA,Kerns RD,Schottenfeld RS

    更新日期:2008-06-01 00:00:00

  • A unique model for treating chronic hepatitis C in patients with psychiatric disorders, substance abuse, and/or housing instability.

    abstract:BACKGROUND:Individuals with psychiatric disease, substance abuse, and/or housing instability have a high prevalence of chronic hepatitis C virus (HCV) infection. However, such individuals are often excluded from treatment for HCV infection because of a perceived inability to adhere to the rigorous medication regimen re...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0b013e31829b1a6c

    authors: Ho CJ,Preston C,Fredericks K,Doorley SL,Kramer RJ,Kwan L,Kamal A

    更新日期:2013-09-01 00:00:00

  • Prospective study of QTc changes among former opiate addicts since admission to methadone maintenance treatment: benzodiazepine risk.

    abstract:OBJECTIVES:To prospectively evaluate QTc changes among methadone maintenance treatment (MMT) patients. METHODS:All 512 opiate addicts newly admitted to 2 MMT clinics had been prospectively studied for 4.5 years. Ninety-one patients were excluded because they were admitted from other MMTs, and 26 were excluded because ...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0b013e3182a8a4f2

    authors: Peles E,Linzy S,Kreek MJ,Adelson M

    更新日期:2013-11-01 00:00:00

  • Together … to take care: multidisciplinary management of hepatitis C virus treatment in randomly selected drug users with chronic hepatitis.

    abstract::Hepatitis C Virus (HCV) infection is treated with peg-interferon α2a or α2b and ribavirin. International studies show that drug user adherence to treatment is 40% to 60% and increases if the patient is in addiction treatment. The aim of the Together To Take Care (TTTC) study was to achieve better adherence to HCV ther...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0b013e3181cae4d0

    authors: Curcio F,Di Martino F,Capraro C,Angelucci F,Bulla F,Caprio N,Cascone A,D'ascoli G,Focaccio F,Gaveglia M,Longobardo A,Martini S,Masucci S,Morra A,Pasquale G,Pisapia R,Plenzik M,Veneruso C,Villano G,Russo M,De Rosa

    更新日期:2010-12-01 00:00:00

  • The Opioid dependent mother and newborn dyad: non-pharmacologic care.

    abstract::Opioid dependent pregnant and post-partum women and their infants are a complex and vulnerable population requiring individualized, comprehensive and multidisciplinary treatment. Though methadone maintenance in the setting of comprehensive service provision during pregnancy significantly improves pregnancy outcomes fo...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0b013e31817e6105

    authors: Velez M,Jansson LM

    更新日期:2008-09-01 00:00:00

  • Characteristics of Patients With Opioid Use Disorder Associated With Performing Overdose Reversals in the Community: An Opioid Treatment Program Analysis.

    abstract:OBJECTIVE:The primary outcome of this study is to identify characteristics of study participants in a large opioid treatment program (OTP) for opioid use disorder (OUD) who used take-home naloxone to perform 1 or more opioid overdose (OD) reversal(s) in the community. METHODS:This 6-month prospective cohort study prov...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0000000000000461

    authors: Katzman JG,Greenberg NH,Takeda MY,Moya Balasch M

    更新日期:2019-03-01 00:00:00

  • A Call to Action to Combat the Opioid Epidemic Among Women.

    abstract::: Acknowledging the needs and challenges of women with opioid use disorder is an essential step to reduce the opioid epidemic in the United States. Efforts that can help women include increasing psychosocial services to address trauma, increasing access to medication treatment for opioid use disorder, reducing barrier...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0000000000000622

    authors: Springer SA,Biondi BE,Frank C,El-Bassel N

    更新日期:2020-09-01 00:00:00

  • The Effect of Substance Use Disorders on the Association Between Guideline-concordant Long-term Opioid Therapy and All-cause Mortality.

    abstract:OBJECTIVE:Patients with substance use disorders (SUDs) prescribed long-term opioid therapy (LtOT) are at risk for overdose and mortality. Prior research has shown that receipt of LtOT in accordance with clinical practice guidelines has the potential to mitigate these outcomes. Our objective was to determine whether the...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0000000000000255

    authors: Gaither JR,Goulet JL,Becker WC,Crystal S,Edelman EJ,Gordon K,Kerns RD,Rimland D,Skanderson M,Justice AC,Fiellin DA

    更新日期:2016-11-01 00:00:00

  • Combined abuse of clonidine and amitriptyline in a patient on buprenorphine maintenance treatment.

    abstract::Buprenorphine/naloxone maintenance therapy is often prescribed in primary care to treat opioid dependence. Previous reports have described concomitant abuse of opioids and clonidine. In this case, a primary care patient on buprenorphine/naloxone maintenance therapy demonstrating altered mental status, hallucinations, ...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0000000000000081

    authors: Seale JP,Dittmer T,Sigman EJ,Clemons H,Johnson JA

    更新日期:2014-11-01 00:00:00

  • The Substance Use Intervention Team: A Preliminary Analysis of a Population-level Strategy to Address the Opioid Crisis at an Academic Health Center.

    abstract:OBJECTIVE:In 2017, an academic health center in Chicago launched the multidisciplinary Substance Use Intervention Team (SUIT) to address opioid misuse across 18 inpatient units and in a new outpatient addiction medicine clinic. This report assesses the first 5 months of implementation and associations with patient heal...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0000000000000520

    authors: Thompson HM,Hill K,Jadhav R,Webb TA,Pollack M,Karnik N

    更新日期:2019-11-01 00:00:00

  • Escalating Opioid Dose Is Associated With Mortality: A Comparison of Patients With and Without Opioid Use Disorder.

    abstract:OBJECTIVE:Prescription Drug Monitoring Programs (PDMPs) are intended to help reduce prescription drug misuse and opioid overdose, yet little is known about the longitudinal patterns of opioid prescribing that may be associated with mortality. This study investigated longitudinal opioid prescribing patterns among patien...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0000000000000458

    authors: Hser YI,Saxon AJ,Mooney LJ,Miotto K,Zhu Y,Yoo CK,Liang D,Huang D,Bell DS

    更新日期:2019-01-01 00:00:00

  • Energy drinks, soft drinks, and substance use among United States secondary school students.

    abstract:OBJECTIVES:Examine energy drink/shot and regular and diet soft drink use among United States secondary school students in 2010-2011, and associations between such use and substance use. METHODS:We used self-reported data from cross-sectional surveys of nationally representative samples of 8th-, 10th-, and 12th-grade s...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/01.ADM.0000435322.07020.53

    authors: Terry-McElrath YM,OʼMalley PM,Johnston LD

    更新日期:2014-01-01 00:00:00

  • Use of conventional, complementary, and alternative treatments for pain among individuals seeking primary care treatment with buprenorphine-naloxone.

    abstract:UNLABELLED:Previous studies have not examined patterns of pain treatment use among patients seeking office-based buprenorphine-naloxone treatment (BNT) for opioid dependence. OBJECTIVES:To examine, among individuals with pain seeking BNT for opioid dependence, the use of pain treatment modalities, perceived efficacy o...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0b013e31826d1df3

    authors: Barry DT,Savant JD,Beitel M,Cutter CJ,Moore BA,Schottenfeld RS,Fiellin DA

    更新日期:2012-12-01 00:00:00

  • Outcome Differences in Neonates Exposed In-Utero to Opioids Managed in the NICU Versus Pediatric Floor.

    abstract:OBJECTIVE:The aim of the study is to determine length of stay and length of treatment in infants with neonatal abstinence syndrome (NAS) in the neonatal intensive care unit (NICU) compared to those in the pediatric floor. METHODS:Retrospective cohort of infants ≥34 weeks gestation admitted with diagnosis of NAS at a s...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0000000000000455

    authors: Lembeck AL,Tuttle D,Locke R,Lawler L,Jimenez P,Mackley A,Paul DA

    更新日期:2019-01-01 00:00:00

  • No change of sleep after 6 and 12 months of methadone maintenance treatment.

    abstract:OBJECTIVE:To determine whether the methadone maintenance treatment (MMT) affects sleep. METHODS:We prospectively followed up the sleep pattern of 23 opiate addicts when admitted to MMT and after 6 and 12 months of treatment. Pittsburgh Sleep Quality Index, pain self-report questionnaires, urine for drug abuse, and one...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0b013e3181e8b6c4

    authors: Peles E,Schreiber S,Hamburger RB,Adelson M

    更新日期:2011-06-01 00:00:00

  • Sex differences in first-admission psychiatric inpatients with and without a comorbid substance use disorder.

    abstract:OBJECTIVES:We assessed sex differences in a sample of first-admission psychiatric inpatients with and without comorbid substance use disorder (SUD) to identify possible risk factors and targets for sex-tailored treatment interventions. METHODS:A retrospective study of first admissions to the University Psychiatry Ward...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0000000000000062

    authors: Gramaglia C,Bert F,Lombardi A,Feggi A,Porro M,Siliquini R,Gualano MR,Torre E,Zeppegno P

    更新日期:2014-09-01 00:00:00

  • Synthetic Cannabis Analogues and Suicidal Behavior: Case Report.

    abstract:INTRODUCTION:Despite growing legal control, a wide range of synthetic cannabis analogues is currently used for recreational purposes, notwithstanding their well adverse outcomes, which appear to be more frequent and more serious than those associated with cannabis use. We present the case report of a patient with paran...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0000000000000335

    authors: Oliveira PMDS,Morais ASF,Madeira NGGF

    更新日期:2017-09-01 00:00:00

  • Lower urinary tract destruction due to ketamine: a report of 4 cases and review of literature.

    abstract::Four young ketamine abusers with lower urinary tract symptoms presented to regional hospitals in Shenzhen, China. Investigations demonstrated contracted bladders and other urinary tract abnormalities. There have been few reports of similar findings in ketamine abusers in the Chinese mainland. We followed up each patie...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章,评审

    doi:10.1097/ADM.0b013e3182312863

    authors: Wu S,Lai Y,He Y,Li X,Guan Z,Cai Z

    更新日期:2012-03-01 00:00:00

  • Group-based strategies for stress reduction in methadone maintenance treatment: what do patients want?

    abstract:OBJECTIVES:To assess methadone maintenance treatment (MMT) patients' willingness to use, and perceived efficacy of, conventional and unconventional group stress reduction treatments. METHODS:A survey, developed by the authors, was administered to 150 MMT patients. RESULTS:Levels of treatment willingness and perceived...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0b013e3181ee77cl

    authors: Barry DT,Beitel M,Breuer T,Cutter CJ,Savant J,Peters S,Schottenfeld RS,Rounsaville BJ

    更新日期:2011-09-01 00:00:00

  • Computerized Cognitive Behavioral Therapy for Substance Use Disorders in a Specialized Primary Care Practice: A Randomized Feasibility Trial to Address the RT Component of SBIRT.

    abstract:OBJECTIVES:Screening, Brief Intervention, and Referral to Treatment (SBIRT) has demonstrated efficacy for addressing unhealthy alcohol use in primary care, yet recent research indicates weaker efficacy for drug use as well as very limited success in referral to specialty care for patients with substance use disorder (S...

    journal_title:Journal of addiction medicine

    pub_type: 杂志文章

    doi:10.1097/ADM.0000000000000663

    authors: Tetrault JM,Holt SR,Cavallo DA,O'Connor PG,Gordon MA,Corvino JK,Nich C,Carroll KM

    更新日期:2020-12-01 00:00:00