A case of tramadol dependence and successful treatment with buprenorphine/naloxone

Tramadol, a synthetic, centrally acting analgesic with weak mu-opioid agonist activity, is often prescribed as an alternative to opioids due to its negligible abuse potential. Although the potential for the abuse of tramadol appeared low when the medication first became available, findings have demonstrated increased rates of abuse with extended time on the market. This case report details the addiction to tramadol of a 39-year-old female serving in the United States Army. At the height of her addiction, she was consuming an average of 1400mg tramadol daily. Eventually the patient entered into residential inpatient treatment for 28 days at our facility. During this time she was successfully titrated to buprenorphine 8mg/naloxone 2mg daily while maintaining abstinence. Patient care transitioned to the outpatient treatment center during which she maintained sobriety with the continued use of buprenorphine/naloxone. This case adds to previous reports of the increasing abuse of tramadol and the need for quality evidence on successful treatments for this escalating concern.

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Discovery of conolidine derivative DS39201083 as a potent novel analgesic without mu opioid agonist activity

Bioorganic & Medicinal Chemistry Letters ◽

10.1016/j.bmcl.2019.05.045 ◽

2019 ◽

Vol 29 (15) ◽

pp. 1938-1942 ◽

Cited By ~ 1

Author(s):

Tsuyoshi Arita ◽

Masayoshi Asano ◽

Kazufumi Kubota ◽

Yuki Domon ◽

Nobuo Machinaga ◽

...

Keyword(s):

Agonist Activity ◽

Opioid Agonist ◽

Mu Opioid

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Developing and Understanding a Hospital-Based Proton Facility: Bringing Physics into Medicine

Technology in Cancer Research & Treatment ◽

10.1177/15330346070060s401 ◽

2007 ◽

Vol 6 (4_suppl) ◽

pp. 1-7

Author(s):

James M. Slater

Keyword(s):

United States Army ◽

The United States ◽

Advanced Technology ◽

Treatment Center ◽

Technology Research ◽

Loma Linda University ◽

Proton Treatment ◽

Army Medical Research ◽

Educational Offering ◽

Radiation Medicine

From October 18 to 20, 2006, a symposium, Developing and Understanding a Hospital-based Proton Facility: Bringing Physics Into Medicine, was held at the Renaissance Esmeralda Resort and Spa, Indian Wells, California. The event was offered by the Department of Radiation Medicine at Loma Linda University (LLU), supported by the Telemedicine and Advanced Technology Research Center (TATRC) and the United States Army Medical Research and Materiel Command (USAMRMC). The meeting was intended to discuss factors involved in planning, developing, and operating a hospital-based proton treatment center. It brought together some of the most distinguished physicists, radiation biologists, and radiation oncologists in the world, and more than 100 individuals participated in the three-day educational offering. This overview reports on the event and introduces several papers written by many of the speakers from their presentations, for publication in this issue of Technology in Cancer Research and Treatment. Both the symposium and the papers are appropriate for this journal: exploitation of technology was one of the underlying themes of the symposium.

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298. Collocation of Hepatitis C Care Continuum with MAT for High-Prevalence, High-Risk Population

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.373 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S161-S161

Author(s):

Shivakumar Narayanan ◽

Ameer Abutaleb ◽

Jennifer Hoffmann ◽

Aaron Greenblatt ◽

Shyam Kottilil ◽

...

Keyword(s):

Hepatitis C ◽

The United States ◽

Treatment Center ◽

Decompensated Cirrhosis ◽

Hcv Rna ◽

High Risk Population ◽

Opioid Agonist ◽

Baltimore City ◽

Care Continuum ◽

High Prevalence

Abstract Background The hepatitis C virus (HCV) epidemic in the United States disproportionately impacts people who inject drugs (PWID) who account for 80% of new infections and have a high prevalence of chronic infection. Baltimore City has the highest case rate of HCV in the state of Maryland with over 25% of new cases statewide occurring in the city. Only 10% of PWID have access to directly acting antiviral (DAA) therapy and are cured of HCV. Medication-assisted treatment (MAT) is currently offered in isolated facilities with limited access to other specialty care. In this study, we collocated HCV care continuum in a MAT facility offering opioid agonist therapy and psychosocial interventions Methods Collocation of HCV care was initiated in an MAT (methadone and buprenorphine) clinic, the University of Maryland Drug Treatment Center (UMDTC) serving over 700 patients, for Opioid Use Disorder (OUD) in Baltimore City (Figure 1). Screening for HCV was expanded through health education of patients and staff and expanded testing. HCV antibody-positive patients were linked to care with an experienced HCV provider or referred to hepatologists (decompensated cirrhosis). Results Most of the attendees were African-American with an average age of 52 years. 354 out of 701 clients attending clinic for methadone/suboxone (50.5%) were screened for HCV. Of the 251 patients who were hepatitis C antibody positive (70% of tested), 54 had undetectable HCV RNA. 46 had no HCV RNA labs available. 151 of the remaining HCV Ab positive patients who had a detectable HCV RNA result were evaluated for treatment (Figure 2). At initial assessment, 45 (48%) with liver fibrosis staged greater than F3, including 25 (27%) with cirrhosis. Sixty-four patients initiated DAA therapy. Fifty-four patients completed treatment (84%). Forty patients achieved sustained virologic response (100%) and 14 patients who completed treatment await SVR labs. Conclusion Collocation of HCV care continuum in MAT setting is an effective way to achieve micro elimination of HCV. The follow-up of this marginalized population still remains challenging given the high rates of homelessness and incarceration. In this regard, coordinated care between MAT settings and prisons are likely to demonstrate successful elimination of hepatitis C. Disclosures All authors: No reported disclosures.

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Buprenorphine for opioid dependence

Mental Health Clinician ◽

10.9740/mhc.n183350 ◽

2013 ◽

Vol 3 (6) ◽

pp. 286-289 ◽

Cited By ~ 1

Author(s):

Reisel Berger

Keyword(s):

United States ◽

Opioid Dependence ◽

The United States ◽

Opioid Use Disorder ◽

Opioid Use ◽

Opioid Agonist ◽

Mu Opioid ◽

Product Availability ◽

Dosing Strategy

Opioid use disorder is a growing problem in the United States that can have devastating consequences on affected individuals. Buprenorphine is a partial mu-opioid agonist that can be used in the treatment of opioid dependence. In this article, the pharmacology of buprenorphine is discussed as is the dosing strategy. Formulations and product availability are mentioned and assessed. Several studies comparing the use of buprenorphine to methadone for opioid dependence are briefly reviewed.

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