Challenges with buprenorphine inductions in the context of the fentanyl overdose crisis: A case series
| Autor: | Samantha Young, Daniel Shearer, Rupinder Brar, Nadia Fairbairn |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Health (social science)
Narcotic Antagonists Medicine (miscellaneous) Context (language use) Article Fentanyl Naloxone Opiate Substitution Treatment medicine Humans business.industry Opioid overdose Opioid use disorder Opioid-Related Disorders medicine.disease Buprenorphine Analgesics Opioid Opiate Overdose Opioid Anesthesia Buprenorphine Naloxone Drug Combination business medicine.drug |
| Zdroj: | Drug Alcohol Rev |
| ISSN: | 1465-3362 0959-5236 |
| Popis: | Introduction and aims North America is currently experiencing an epidemic of opioid overdose deaths, driven by the proliferation of fentanyl in the street drug market. Although buprenorphine/naloxone (BUP/NX) is an evidence-based, first-line opioid agonist for the management of opioid use disorder, a key challenge in its prescribing lies in the fact that it can precipitate opioid withdrawal during its initial induction process. At this time, there is minimal literature on the BUP/NX induction process in individuals who use illicit fentanyl regularly. Design, methods and results A case series from a Vancouver, Canada addiction medicine clinic of three fentanyl-exposed patients who experienced unexpected, precipitated withdrawal when initiating BUP/NX. Discussion and conclusion These cases describe incidents of precipitated opioid withdrawal occurring after unusually long periods of fentanyl abstention. Although fentanyl is experienced as a short-acting opioid, the drug persists much longer in the body's peripheral tissues. Here, we highlight the new challenges fentanyl may pose to current BUP/NX induction strategies, and explore the possibility of a long-acting pharmacokinetic effect of fentanyl in the setting of repeated illicit use. |
| Databáze: | OpenAIRE |
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