Buprenorphine Therapy of Opiate Addiction

, by Kintz, Pascal; Marquet, Pierre; Fraser, Albert D.

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ISBN: 9781588290311 | 158829031X
Cover: Hardcover
Copyright: 2/1/2002

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In Buprenorphine Therapy of Opiate Addiction, participating physicians and toxicologists summarize and evaluate their experiences with five years of intensive buprenorphine therapy. They cover all aspects of its use, including the pharmacology, conditions of delivery, risks from use with other psychoactive drugs, toxicology and related deaths, as well as its testing in blood, urine, tissue, and hair. Special attention is given to comparing the long-term care of opiate-dependent patients using high-dose buprenorphine vs methadone, and to explaining the differences in treatment, administration, and delivery. The authors also describe how buprenorphine is currently prescribed and monitored in France and Australia, and review all the latest advances in analytical techniques for the determination of buprenorphine and its metabolites in biological fluids and tissues.

Foreword

Albert D. Fraser

Preface

vii

Contributors

Pharmacology of High-Dose Buprenorphine

(12)

Pierre Marquet

Introduction

(1)

Pharmacokinetic Properties

(4)

Absorption and Bioavailability

(2)

Distribution

(2)

Metabolism

(1)

Excretion

(1)

Pharmacodynamic Properties

(3)

Administration Schedules

(1)

Clinical Effects of Buprenorphine

(1)

Conclusion

(4)

References

(4)

Controlled Drug Administration Studies of High-Dose Buprenorphine in Humans

(16)

Marilyn A. Huestis

Introduction

(1)

Bioavailability

(2)

Dose-Effect Profiles

(1)

Abuse Liability

(3)

Toxicity

(2)

Safety and Abuse Liability of High-Dose Intravenous Buprenorphine

(2)

Conclusion

(6)

References

(5)

High-Dose Buprenorphine for Treatment of Opioid Dependence

(22)

Eric C. Strain

Introduction

(1)

Buprenorphine Solution vs Tablets

(1)

Efficacy of Buprenorphine vs Placebo: Clinical Trials

(3)

Summary of Placebo-Controlled Studies

(1)

Efficacy of Buprenorphine vs Other Medications: Clinical Trials

(10)

Summary of Studies Comparing Buprenorphine to Other Medications

(1)

Safety and Side Effects of Buprenorphine

(1)

Summary and Conclusions

(6)

Acknowledgment

(1)

References

(4)

Foreseeable Advantages and Limits of Buprenorphine-Naloxone Association

(18)

Michel Mallaret

Maurice Dematteis

Celine Villier

Claude Elisabeth Barjhoux

Chantal Gatignol

Introduction

(1)

Advantages of Buprenorphine-Naloxone Association

(7)

Advantages of Opiate-Naloxone Association: Lessons of the Past

(1)

Epidemic of Pentazocine and Tripelennamine Abuse in the United States

(1)

Epidemic of Analgesic Buprenorphine Abuse in New Zealand

(1)

Buprenorphine and Naloxone: A Complex and Controversial Pharmacology

(1)

Clinical Aspects

(1)

Pharmacokinetic/Pharmacodynamic Advantages of Associated Naloxone in BupNx Combination

(1)

Sublingual Naloxone in BupNx Tablets Does Not Decrease Buprenorphine Effects

(1)

Sublingual Naloxone in BupNx Tablets Does Not Decrease Blockade Effects of Buprenorphine in Opioid-Dependent Patients

(1)

Sublingual Naloxone in BupNx Tablets Does Not Precipitate Withdrawal Symptoms in Opioid-Dependent Patients

(1)

Is the BupNx Combination Effective for Detoxification or Treatment of Depressive Symptoms in Opioid-Dependent Patients?

(1)

What Is the Abuse Liability of Intravenous BupNx Combination in Nonopioid-Dependent and Opioid-Dependent Patients?

(2)

Intravenous Naloxone May Decrease Respiratory Depression by Buprenorphine

(1)

What Will Be the Epidemiological Consequences and Potential Economic Impact of the Use of BupNx Combination?

(1)

Limits of Buprenorphine-Naloxone Association

(4)

Potential Risk of Inefficacy of Naloxone in BupNx Combination

(1)

Abuse Liability of Intravenous BupNx Combination: Low But Still Possible

(1)

Adverse Buprenorphine Reactions and Sublingual BupNx Combination

(1)

Respiratory Depression

(1)

Involuntary Overdoses

(1)

Experimental Buprenorphine Hepatotoxicity

(1)

Specific Risks in Office-Based Treatment (BupNx Combination) of Opiate Dependence

(1)

Conclusion

(6)

References

(5)

Buprenorphine Maintenance Treatment in Primary Care: An Overview of the French Experience and Insight Into the Prison Setting

(14)

Marc Deveaux

Jean Vignau

Introduction

(1)

Implementation of BMT Through French Primary Care System

(2)

A Late But Considerable Concession to Harm Reduction Paradigm

(1)

Legal Framework of Therapeutic Use of Buprenorphine

(1)

Essential Landmarks of French Health Services

(1)

Opioid Maintenance Treatments

(1)

Observable Effects of French Policy

(4)

Is BMT Accessible and Acceptable?

(1)

Is BMT Safe?

(1)

Data from Preregistration Studies

(1)

Data from French Experience

(1)

Is BMT Effective in Controlling Opiate Addiction and Preventing Subsequent Relapses?

(1)

Prison

(2)

Drug Addicts in French Prisons

(1)

Legal Framework of BMT in Prison

(1)

Procedures in Loos-lez-Lille Prison

(1)

Conclusion

(5)

Acknowledgments

(1)

References

(4)

Buprenorphine as a Viable Pharmacotherapy in Australia

(6)

John H. Lewis

Introduction

(1)

Buprenorphine

(2)

National Evaluation of Pharmacotherapies for Opioid Dependence

(1)

Conclusion

(3)

Acknowledgments

(1)

References

(2)

Separative Techniques for Determination of Buprenorphine

(20)

Vincent Cirimele

Introduction

(1)

Determination of Buprenorphine in Blood

(6)

Determination of Buprenorphine in Urine

(3)

Determination of Buprenorphine in Biological Tissues

(1)

Determination of Buprenorphine in Hair

(7)

Conclusion

106

(3)

References

106

(3)

Buprenorphine-Related Deaths

109

(10)

Pascal Kintz

Introduction

109

(1)

Forensic Aspects

110

(1)

Buprenorphine Fatalities

110

(5)

Conclusion

115

(4)

References

116

(3)

Pharmacology of Opiates During Pregnancy and in Neonates

119

(6)

Pierre Marquet

Introduction

119

(1)

Perinatal Pharmacokinetics of Opiates

119

(1)

In Utero

119

(1)

Transfer Through Placenta and Distribution in Fetus

119

(1)

Transfer Through Blood-Brain Barrier

120

(1)

Postnatal

120

(1)

Perinatal Pharmacodynamics of Opiates

120

(2)

Opioid Receptors and Development of Embryos

120

(1)

Perinatal Effects of Exogenous Opiates

121

(1)

On Development

121

(1)

On Opioid System

122

(1)

Maintenance Treatments During Pregnancy

122

(3)

References

123

(2)

Case Study of Neonates Born to Mothers Undergoing Buprenorphine Maintenance Treatment

125

(12)

Pierre Marquet

Pierre Lavignasse

Jean-Michel Gaulier

Gerard Lachatre

Introduction

125

(1)

Clinical Findings

126

(4)

Neonates Included

126

(1)

Questionnaire and Toxicological Survey of Mothers

126

(4)

Neonates' Outcomes

130

(1)

Toxicological Investigations

130

(3)

Materials and Methods

130

(1)

Results

131

(2)

Discussion

133

(1)

Conclusion

134

(3)

Acknowledgments

135

(1)

References

135

(2)

Buprenorphine and Pregnancy: A Comparative, Multicenter Clinical Study of High-Dose Buprenorphine vs Methadone Maintenance

137

(10)

Claude Lejeune

Sandrine Aubisson

Laurence Simmat-Durand

Fabrice Cneude

Martine Piquet

Introduction

137

(1)

Materials and Methods

138

(1)

Results

139

(4)

Discussion

143

(2)

Conclusion

145

(2)

Acknowledgments

145

(1)

References

145

(2)

Index

147

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Buprenorphine Therapy of Opiate Addiction

Summary

Table of Contents

Supplemental Materials