scholarly journals Subcutaneous Extended-Release Buprenorphine Use in Pregnancy

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Craig V. Towers ◽  
Heather Deisher
Keyword(s):  
Extended Release ◽  
Opioid Use Disorder ◽  
Adverse Outcomes ◽  
Extensive Literature ◽  
Opioid Use ◽  
Sublingual Buprenorphine ◽  
Medication Assisted Treatment ◽  
Urine Drug ◽  
Long Acting ◽  
In Pregnancy

Background. Opioid use disorder (OUD) in pregnancy is managed by medication-assisted treatment. Sublingual buprenorphine is one option, but subcutaneous extended-release buprenorphine (Sublocade®) is an alternate form administered in monthly injections. Through an extensive literature search, we did not find any prior publication on the use of Sublocade in pregnancy. Case. Two patients with OUD switched from sublingual buprenorphine to Sublocade. One patient received a total of eight injections and then discovered she was pregnant. Based on ultrasound dating, the last 5 administrations occurred during her pregnancy. The second patient received 6 injections with the last occurring at the time of her last menstrual period. Both declined further injections, as well as oral buprenorphine. Serial urine drug screens remained positive for buprenorphine through delivery in both cases. Neither the mothers nor the neonates experienced withdrawal symptoms or adverse outcomes. No birth anomalies were found. Discussion. Though further research is needed regarding the use of Sublocade in pregnancy, it is likely that other pregnancies will occur during this treatment modality. If this long-acting form of buprenorphine medication is found to be safe, it might play a role in managing some pregnant patients with OUD.

scholarly journals Prenatal intent and postpartum receipt of long-acting reversible contraception among women receiving medication-assisted treatment for opioid use disorder

Contraception ◽  
2019 ◽  
Vol 99 (1) ◽  
pp. 36-41 ◽  
Author(s):  
Anupama Kotha ◽  
Beatrice A. Chen ◽  
Lauren Lewis ◽  
Shannon Dunn ◽  
Katherine P. Himes ◽  
...  
Keyword(s):  
Opioid Use Disorder ◽  
Opioid Use ◽  
Medication Assisted Treatment ◽  
Long Acting

scholarly journals Using Microdosing to Induct Patients Into a Long-Acting Injectable Buprenorphine Depot Medication in Low Threshold Community Settings: A Case Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Joseph Tay Wee Teck ◽  
Alexander Baldacchino ◽  
Lauren Gibson ◽  
Con Lafferty
Keyword(s):  
Methadone Treatment ◽  
Opioid Use Disorder ◽  
High Dose ◽  
Opioid Use ◽  
Access To Treatment ◽  
Medication Assisted Treatment ◽  
Low Threshold ◽  
Healthcare Innovation ◽  
Long Acting

Healthcare innovation has never been more important as it is now when the world is facing up to the unprecedented challenges brought by the COVID-19 pandemic. Within addictions services in Scotland, the priority has been to tackle our rising drug related death rate by maintaining and improving access to treatment while protecting frontline workers and managing operational challenges as a result of the pandemic. We present here a case study of five patients with opioid use disorder whose treatment represents a confluence of three important Medication Assisted Treatment (MAT) service innovations. The first was a low threshold drop in and outreach MAT service to rapidly and safely initiate opiate replacement therapy (ORT). The second was the provision of a microdosing regimen to enable same day induction to oral buprenorphine while minimizing the risk of precipitated opioid withdrawals and/or treatment disengagement. The third was rapid transitioning to an injectable long-acting buprenorphine depot which reduced unnecessary face to face patient contact and treatment non-adherence. This case study of five patients highlights the valuable role that buprenorphine microdosing can play in making induction to long-acting buprenorphine depot feasible to a broader range of patients, including those on a high dose methadone treatment regime.

The Spiritual and Ethical Implications of Medication-Assisted Recovery in Pregnancy: Preserving the Dignity and Worth of Mother and Baby

2019 ◽  
Vol 46 (3) ◽  
Author(s):  
Cayce Watson ◽  
April Mallory ◽  
Amy Crossland
Keyword(s):  
Pregnant Women ◽  
Work Practice ◽  
Social Work Practice ◽  
Opioid Use Disorder ◽  
Current Evidence ◽  
Opioid Use ◽  
Community Based Interventions ◽  
Medication Assisted Treatment ◽  
Ethical Implications ◽  
In Pregnancy

Reducing harm, supporting autonomy, and affirming dignity are foundational values in social work practice.  Attempts to balance personal beliefs, faith, and ethical responsibilities with client-centered therapies can elicit internal conflicts for practitioners.  These challenges are even more evident when working with opioid dependent pregnant women in medication-assisted recovery.  Medication-assisted treatment (MAT) is evidence-based and a recommended first-line approach for treating opioid use disorder in pregnancy; however, neonates exposed to opiates, either street drugs or MAT, may develop neonatal abstinence syndrome (NAS).  Disagreement among treatment providers, insufficient resources for pregnant clients, and incomplete service delivery compound the stigma surrounding pregnant women living with opioid misuse.  This article explores current evidence and best practices for pregnant women with opioid use disorder, the spiritual and ethical dilemmas of social workers supporting a harm reduction approach, and recommendations for individual and community-based interventions that support the dignity and worth of both mother and baby.

Group Prenatal Care for Women Receiving Medication‐Assisted Treatment for Opioid Use Disorder in Pregnancy: An Interprofessional Approach

2019 ◽  
Vol 64 (2) ◽  
pp. 217-224 ◽  
Author(s):  
Mary Beth Sutter ◽  
Hannah Watson ◽  
Ariele Bauers ◽  
Kate Johnson ◽  
Mandy Hatley ◽  
...  
Keyword(s):  
Prenatal Care ◽  
Opioid Use Disorder ◽  
Group Prenatal Care ◽  
Opioid Use ◽  
Medication Assisted Treatment ◽  
In Pregnancy

scholarly journals Cannabis use in patients treated for opioid use disorder pre- and post-recreational cannabis legalization in Canada

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Tea Rosic ◽  
Nitika Sanger ◽  
Balpreet Panesar ◽  
Gary Foster ◽  
David C. Marsh ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Conditional Logistic Regression ◽  
Opioid Use Disorder ◽  
Cannabis Use ◽  
Opioid Use ◽  
Cross Sectional ◽  
Medication Assisted Treatment ◽  
Use Patterns ◽  
Urine Drug

Abstract Background As the legalization of recreational cannabis becomes more widespread, its impact on individuals with substance use disorders must be studied. Amidst an ongoing opioid crisis, Canada’s legalization of recreational cannabis in October 2018 provides an important setting for investigation. We examined changes to cannabis use patterns in patients receiving medication-assisted treatment (MAT) for opioid use disorder (OUD) following legalization. Methods This study includes cross-sectional data from 602 participants recruited 6 months pre-legalization and 788 participants recruited 6 months post-legalization, providing information on cannabis use. Regression analysis was used to estimate the association between legalization and cannabis use patterns. We collected longitudinal urine drug screens (UDSs) detecting cannabis-metabolites for 199 participants recruited pre-legalization and followed prospectively post-legalization. Conditional logistic regression was used to assess the association between legalization and UDS results. Results Past-month cannabis use was self-reported by 54.8 and 52.3% of participants recruited pre- and post-legalization, respectively. Legalization was not associated with changes in any measured cannabis characteristics: cannabis use (OR 0.91, 95% CI 0.73–1.13), days of use/month (B -0.42, 95% CI - 2.05-1.21), money spent, or cannabis source. There was no association between legalization and prevalence of cannabis use on UDS (OR 1.67, 95% CI 0.93–2.99) or percentage of cannabis-positive UDSs (OR 1.00, 95% CI 0.99–1.01). Participants overwhelmingly reported that legalization would have no impact on their cannabis use (85.7%). Conclusions Amongst patients treated for OUD, no significant change in cannabis use was observed following legalization; however, high rates of cannabis use are noted.

Interest in long-acting injectable buprenorphine among syringe services program participants

2021 ◽  
Vol 17 (7) ◽  
pp. 59-67
Author(s):  
Hannah Epstein, BS ◽  
Andres Perez-Correa, MD ◽  
Jason Beltre, BS ◽  
Christine Fitzsimmons, ASN ◽  
Pia Marcus, BA ◽  
...  
Keyword(s):  
Outcome Measure ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Sublingual Buprenorphine ◽  
Item Questionnaire ◽  
Treatment Models ◽  
Median Level ◽  
Monthly Injection ◽  
Long Acting ◽  
Buprenorphine Treatment

Objective: To examine syringe services program (SSP) participants’ interest in long-acting injectable buprenorphine.Design: SSP participants completed a 136-item questionnaire by phone. Items assessed quantitative ratings of interest in sublingual and injectable buprenorphine, preference for sublingual versus injectable buprenorphine, and reasons for preferences.Setting: Two large urban SSPs.Participants: SSP participants ≥18 years of age with current or lifetime opioid use disorder (OUD).Main outcome measure(s): (1) Interest in sublingual and injectable buprenorphine, respectively, on a scale from 0 to 10 (0 = no interest and 10 = high interest); and (2) preference for sublingual buprenorphine versus injectable buprenorphine. Participants were also asked whether they agreed with statements that presented potential reasons for preferring each formulation.Results: A total of 104 unique participants were interviewed, of which 72 (69 percent) were currently receiving or considering buprenorphine treatment. Among these 72 participants, the median level of interest in starting or continuing sublingual buprenorphine was 8 out of 10 (interquartile range [IQR]: 6-10) and in starting injectable buprenorphine was 5 out of 10 (IQR: 1-9). Thirty-six (50 percent) preferred sublingual, 27 (38 percent) preferred injectable, and 9 (13 percent) preferred neither or declined to answer. Participants who preferred injectable buprenorphine most commonly agreed that the convenience of the monthly injection was the reason for their preference.Conclusions: Among SSP participants with OUD, we found moderate interest in injectable buprenorphine. Introducing this new form of buprenorphine treatment at SSPs could help meet the needs of individuals who are not well-served by standard OUD treatment models.

scholarly journals Buprenorphine for Medication-Assisted Treatment of Opioid Use Disorder in Pregnancy: Relationship to Neonatal Opioid Withdrawal Syndrome

2017 ◽  
Vol 07 (04) ◽  
pp. e215-e222 ◽  
Author(s):  
Niraj Chavan ◽  
Kristin Ashford ◽  
Amanda Wiggins ◽  
Michelle Lofwall ◽  
Agatha Critchfield
Keyword(s):  
Withdrawal Syndrome ◽  
Opioid Use Disorder ◽  
Opioid Withdrawal ◽  
Study Cohort ◽  
Urine Drug Screen ◽  
Opioid Use ◽  
Medication Assisted Treatment ◽  
Positive Urine ◽  
Opioid Withdrawal Syndrome ◽  
In Pregnancy

Objective To examine the relationship between antepartum buprenorphine dose for medication-assisted treatment (MAT) of opioid use disorder (OUD) and incident neonatal opioid withdrawal syndrome (NOWS). Study Design We performed a prospective cohort study of pregnant women with a singleton gestation diagnosed with OUD and receiving buprenorphine for MAT at a tertiary care academic institution from July 2015 to January 2017. We divided the study cohort into two groups—pregnancies with versus without NOWS. Substance abuse patterns in pregnancy, maternal, and neonatal clinical outcomes were compared. Results The incidence of NOWS was 31.11% (n = 28/90) in our study cohort. Pregnancies with NOWS had a significantly higher rate of benzodiazepine positive urine tests and number of positive urine drug screen (UDS) results for illicit opioids. The group without NOWS had significantly higher number of patients with an appropriate UDS result at delivery through postpartum. Rates of neonatal intensive care unit (NICU) admission, length of NICU stay, and maximum Finnegan score were significantly higher in the group with NOWS. Neither the initial (10.6 ± 5.2 versus 10.3 ± 4.8 mg, p = 0.80) nor the final buprenorphine doses (13.3 ± 5.1 versus 13.0 ± 4.6 mg, p = 0.81) were significantly different between study groups. Conclusion The occurrence of NOWS was not related to buprenorphine dose used for MAT.

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