2018
DOI: 10.1007/s13181-018-0685-1
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Pharmacologic Treatment of Opioid Use Disorder: a Review of Pharmacotherapy, Adjuncts, and Toxicity

Abstract: Opioid use disorder continues to be a significant source of morbidity and mortality in the USA and the world. Pharmacologic treatment with methadone and buprenorphine has been shown to be effective at retaining people in treatment programs, decreasing illicit opioid use, decreasing rates of hepatitis B, and reducing all cause and overdose mortality. Unfortunately, barriers exist in accessing these lifesaving medications: users wishing to start buprenorphine therapy require a waivered provider to prescribe the … Show more

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Cited by 67 publications
(61 citation statements)
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References 203 publications
(222 reference statements)
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“…Moreover, it also binds N-methyl-D-aspartate receptor as a weak antagonist (28). Methadone is a potent and long-acting opioid and its PK and PD characteristics have made it the most used opioid for substitution therapy in opioid dependence (29). However, methadone is also a valuable drug in the management of chronic pain especially in cancer pain.…”
Section: Methadonementioning
confidence: 99%
“…Moreover, it also binds N-methyl-D-aspartate receptor as a weak antagonist (28). Methadone is a potent and long-acting opioid and its PK and PD characteristics have made it the most used opioid for substitution therapy in opioid dependence (29). However, methadone is also a valuable drug in the management of chronic pain especially in cancer pain.…”
Section: Methadonementioning
confidence: 99%
“…While opioid medications are CONTACT Benjamin Rolland benjrolland@gmail.com Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, PĂŽle MOPHA, 95 Bd Pinel, Bron 69500, France commonly indicated for treating pain [8], when used as OMTs, they have their specific indication and their specific rules of use. Maintenance antagonist treatments, such as long-acting naltrexone, have also proven some efficacy [9], but are regarded as second-choice treatment, that is, if OMTs have been ineffective or were not available. Retention rates with long-acting antagonists are supposed to be lower to those of OMTs, even if results have been somewhat contradictory on this issue [10,11].…”
Section: Current Best Treatments For Opioid Dependencementioning
confidence: 99%
“…Based on its mechanism of action, it can be speculated that overdose of lofexidine will lead to similar symptoms as that of clonidine but the reports on lofexidine toxicity are lacking. Although there is no strong evidence, in order to treat lofexidine toxicity, we can use intravenous (IV) naloxone to produce a state of opioid withdrawal in opioid-dependent patients which can counteract some of the symptoms of lofexidine toxicity [30].…”
Section: Reviewmentioning
confidence: 99%