Lynn E. Sullivan, MD; David A. Fiellin, MD
Sullivan LE, Fiellin DA. Narrative Review: Buprenorphine for Opioid-Dependent Patients in Office Practice. Ann Intern Med. 2008;148:662-670. doi: 10.7326/0003-4819-148-9-200805060-00006
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Published: Ann Intern Med. 2008;148(9):662-670.
The profile of opioid dependence in the United States is changing. Abuse of prescription opioids is more common than that of illicit opioids: Recent data indicate that approximately 1.6 million persons abuse or are dependent on prescription opioids, whereas 323Â 000 abuse or are dependent on heroin. Despite this prevalence, nearly 80% of opioid-dependent persons remain untreated. One option for expanding treatment is the use of buprenorphine and the buprenorphineâ€“naloxone combination. Buprenorphine is a partial opioid agonist that can be prescribed by trained physicians and dispensed at pharmacies.
This article addresses the clinical presentation of a patient with opioid dependence and describes the relatively new practice of office-based treatment with buprenorphineâ€“naloxone. The different components of treatment; the role of the physician who provides this treatment; and the logistics of treating this growing, multifaceted patient population are also examined.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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