In pooled analyses of the 2 studies, consistently greater reduction was seen in MADRS scores from baseline for BUP/SAM 2mg/2mg versus placebo at multiple time points, including EOT and average change from baseline to week three through EOT.
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After expansion, there was a significant increase in buprenorphine with naloxone fills per 100,000 county residents in expansion vs non-expansion counties (8.7).
In their article, the authors report on two patients who used kratom to self-treat their chronic pain after they could no longer receive opioid analgesics from healthcare providers.
Overall, 11.1% of buprenorphine exposures were for adolescents; 77.1% of these were intentional, including 12% involving suspected suicide, and multiple substances were involved in 27.7%.
Compared to other commonly used opioids, buprenorphine offers a ceiling effect for respiratory depression and less abuse potential, less cognitive impairment, and less constipation.
Buprenorphine is a partial agonist of the mu-receptor and an antagonist of the kappa receptor, which contributes to its analgesic effects.
Results showed that the mean costs over the next 30 days after ED visits were $1,752, $1,805 and $1,977 for ED-initiated buprenorphine, referral alone and brief intervention with facilitated referral, respectively.
The main reasons that physicians with waivers indicated no willingness to increase prescribing were lack of belief in agonist treatment (odds ratio, 3.98), lack of time for additional patients (odds ratio, 5.54), and belief that reimbursement rates are insufficient (odds ratio, 2.50).
Walsh, SL et al. “Effect of Buprenorphine Weekly Depot (CAM2038) and Hydromorphone Blockade in Individuals With Opioid Use Disorder.” DOI: 10.1001/jamapsychiatry.2017.1874
Kraft, WK et al. “Buprenorphine for the Treatment of the Neonatal Abstinence Syndrome.” DOI: 10.1056/NEJMoa1614835