Adjunctive Counseling During Brief and Extended Buprenorphine-Naloxone Treatment for Prescription Opioid Dependence

Background and aims: Tramadol is an opioid agonist which can be potentially used for maintenance treatment of patients with opioid use disorders. This chart review presents the characteristics of individuals with an ICD 10 diagnosis of opioid dependence who were maintained on tramadol for a period of at least 6 months.Methods: Records of patients seeking treatment for opioid dependence from the outpatient clinic of the National Drug Dependence Treatment Centre, Ghaziabad, India were screened. One hundred consecutive patients who received tramadol for more than 6 months were included.Results: The sample comprised exclusively of males and had a mean age of 40.9 years. The median dose of tramadol at initiation and continuation was 300 mg/ day. Sixty-two patients achieved complete abstinence during the course of treatment. Greater age, longer duration of opioid use, and better follow-up adherence were associated with abstinent status. The rates of abstinence were higher among those presenting with natural opioid use as compared to others (prescription opioid use or heroin use).Conclusion: Tramadol can be an alternative medication for harm reduction in select group of patients with opioid dependence. Further research is required to strengthen the evidence base of rational use of tramadol for maintenance treatment of patients with opioid dependence.

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Review of perioperative pain management of opioid-dependent patients

Journal of Opioid Management ◽

10.5055/jom.2016.0344 ◽

2016 ◽

Vol 12 (4) ◽

pp. 289 ◽

Cited By ~ 6

Author(s):

Nalini Vadivelu, MD ◽

Sukanya Mitra, MD, MAMS ◽

Alice M. Kai, BA ◽

Gopal Kodumudi, MS ◽

Karina Gritsenko, MD

Keyword(s):

Drug Addiction ◽

Pain Control ◽

Opioid Dependence ◽

Prescription Opioid ◽

Opioid Use ◽

Postoperative Rehabilitation ◽

Rehabilitation Process ◽

Perioperative Pain Management ◽

Prescription Opioid Use ◽

Effective Analgesia

Opioid dependence can occur due to prescription opioid use, recreational opioid use, or as a result of opioid use for the treatment of drug addiction. Pain control in these patients is truly a challenge. It is important to understand the patient's condition such as the phenomenon of drug dependence, drug addiction, and pseudo-addiction to provide effective analgesia. This may be accomplished using appropriate multimodal therapies and by treatment of coexisting diseases such as anxiety. The goal is to provide effective analgesia, prevent cognitive and emotional problems, and produce a positive postoperative rehabilitation process. Multimodal options include pharmacological and nonpharmacological approaches, psychological support, and interventional pain procedures, all focused toward providing optimal pain control while preventing undertreatment, withdrawal symptoms, and other complications.

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Prescription Opioid Dependence: Relapses Associated with Shorter Treatment Course

MD Conference Express ◽

10.1177/155989771004008 ◽

2010 ◽

Vol 10 (4) ◽

pp. 13-14

Author(s):

C. Helwick ◽

R. D. Weiss

Keyword(s):

Opioid Dependence ◽

Prescription Opioid

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Correlates of Nine-Month Retention following Interim Buprenorphine-Naloxone Treatment in Opioid Dependence: A Pilot Study

Journal of Addiction ◽

10.1155/2016/6487217 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

A. Håkansson ◽

C. Widinghoff ◽

T. Abrahamsson ◽

C. Gedeon

Keyword(s):

Pilot Study ◽

Opioid Dependence ◽

Pilot Trial ◽

Treatment Phase ◽

Full Scale ◽

Urine Samples ◽

Interim Phase ◽

Other Substances ◽

Baseline Characteristics ◽

Naloxone Treatment

Interim medication-only treatment has been suggested for the initiation of opioid maintenance treatment (OMT) in opioid-dependent subjects, but this rarely has been studied using buprenorphine instead of methadone. Following a pilot trial assessing interim buprenorphine-naloxone treatment in order to facilitate transfer into OMT, we here aimed to study retention, and potential correlates of retention, in full-scale treatment. Thirty-six patients successfully referred from a waiting list through an interim treatment phase were followed for nine months in OMT. Baseline characteristics, as well as urine analyses during the interim phase and during full-scale OMT, were studied as potential correlates of retention. The nine-month retention in OMT was 83 percent (n=30). While interim-phase urine samples positive for benzodiazepines did not significantly predict dropout from full-scale OMT (p=0.09), urine samples positive for benzodiazepines within full-scale OMT were significantly associated with dropout (p<0.01), in contrast to other substances and baseline characteristics. Retention remained high through nine months in this pilot study sample of patients referred through buprenorphine-naloxone interim treatment, but use of benzodiazepines is problematic, and the present data suggest that it may be associated with treatment dropout.

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