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Selective Review and Commentary on Emerging Pharmacotherapies for Opioid Addiction.

Substance Abuse and Rehabilitation 2011;2:180-188 [doi: 10.2147/SAR.S20895]

Walter Ling, MD (Integrated Substance Abuse Programs, PR Node), Larissa Mooney, MD (Integrated Substance Abuse Programs, UCLA, PR Node), Min Zhao (Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai), Suzanne Nielsen (CTN INVEST Fellow, Integrated Substance Abuse Programs, PR Node), Matthew Torrington, MD (Integrated Substance Abuse Programs, PR Node), Karen Miotto, MD (Integrated Substance Abuse Programs, PR Node).

Pharmacotherapies for opioid addiction under active development in the U.S. include lofexidine (primarily for managing withdrawal symptoms) and Probuphine®, a distinctive mode of delivering buprenorphine for six months, thus relieving patients, clinicians, and regulatory personnel from most concerns about diversion, misuse, and unintended exposure in children. In addition, two recently approved formulations of previously proven medications are in early phases of implementation. The sublingual film form of buprenorphine + naloxone (Suboxone®) provides a less divertible, more quickly administered, more child-proof version than the buprenorphine + naloxone sublingual tablet. The injectable depot form of naltrexone (Vivitrol®) ensures consistent opioid receptor blockade for one month between administrations, removing concerns about medication compliance. The clinical implications of these developments have attracted increasing attention from clinicians and policymakers in the U.S. and around the world, especially given that human immunodeficiency virus/acquired immunodeficiency syndrome and other infectious diseases are recognized as companions to opioid addiction, commanding more efforts to reduce opioid addiction.

While research and practice improvement efforts continue, reluctance to adopt new medications and procedures can be expected, especially considerations in the regulatory process and in the course of implementation. Best practices and improved outcomes will ultimately emerge from continued development efforts that reflect input from many quarters. (Article (Peer-Reviewed), PDF, English, 2011)

Keywords: Buprenorphine | Buprenorphine/Naloxone | Naltrexone | Opioid dependence | Pharmacological therapy | Substance Abuse and Rehabilitation (journal)

Document No: 774, PMID: 24474855, PMCID: PMC3846315.

Submitted by Harold Perl, PhD, CCTN (10/28/2011).

Ling, Walter search mail
Mooney, Larissa search mail
Zhao, Min search
Nielsen, Suzanne search mail
Torrington, Matthew search mail
Miotto, Karen search mail

Supported by a grant from the National Institute on Drug Abuse to the University of Washington Alcohol and Drug Abuse Institute.
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Updated 10/2011 --