Special Issue on Buprenorphine
“Buprenorphine: Clinical and Public Policy Implications”
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Journal of Opioid Management (JOM) is pleased to present a special issue, Buprenorphine: Clinical and Public Policy Implications focused on all aspects of the use of buprenorphine in medicine. We will also expand this special issue to broaden the knowledge base on buprenorphine, its potential to replace NSAIDs in the healing pharmacopoeia and as a pharmacological tool for addiction. This issue will provide a comprehensive road-map for medical professionals prescribing buprenorphine, its proper utilization in clinical practice and the public policy aspects.
Details on this Special Issue on Buprenorphine
We are pleased to announce that this special issue will be co-led by Mary Lynn McPherson, PharmD, MA, MDE, BCPS, CPE and Mellar P. Davis, MD, FCCP, FAACP.
Dr. McPherson and Dr. Davis have been thought leaders in the field of opioids for decades and we look forward to their leadership on this special issue.
In a 2019 report, The Best Practices Inter-Agency Task Force recognized the importance of buprenorphine in the management of chronic pain and recommended it as the opioid of first choice if chronic pain is considered sufficient to require an opioid.1 The task force also noted that the safety profile was on par with acetaminophen. And with advancements in buccal/sublingual delivery, bio-availability is greatly increased.2
In a Letter to the JOM Editor, Dr. Michael Krees eloquently stated:
“The Task Force continues to endorse the long established step ladder pain paradigm which locates acetaminophen and NSAIDs on the first rung if pain is considered severe enough to require pharmacologic intervention. The Report does not include an explanation for its exclusion of acute pain. Perhaps there is concern regarding the initial cost of buprenorphine compared to the initial cost of commonly used full agonists such as oxycodone, codeine, etc. However, there is considerable evidence that the total cost of pain care ("hidden costs") is far greater for NSAIDs compared to opioids. Up to 28 percent of hospitalizations3 are due to severe NSAID side effects compared to 4 percent for opioids—but near zero for buprenorphine.4,6 An Italian study reported that "the inappropriate use of NSAIDs" had a yearly cost of over 500 million Euros compared to less than 140 million Euros for opioids.7 The side effects related to NSAID use are strongly related to age. The US is an aging population, accordingly the number of NSAID related side effects can be anticipated to continue to increase. If an analgesic was to be chosen solely according to side effect profile, buprenorphine would by far be preferred over any NSAID. Even if concerns regarding cost benefit and safety profile favor buprenorphine, providers will remain reluctant to prescribe buprenorphine more widely until sufficient educational efforts are made to alter the widespread perception that buprenorphine is a difficult drug to use and best left to the addiction specialist. If not a difficult drug, why the need for a waiver? The majority of medical providers are not aware that a waiver is only necessary when treating opioid use disorder/addiction. If pcps and emergency physicians were able prescribe buprenorphine for both acute as well as chronic pain, they will be relieved of the ever present anxiety that treatment can lead to respiratory depression or death.
I hope you will agree that a critical examination of the current pain paradigm is a worth subject for a future issue of the Journal, which I hope will eventually lead to a change in the pain paradigm that promotes both practice efficiency and patient safety.”
Dr. Michael K. Krees, MD, MPH, Letter dated Nov. 19, 2019
Journal of Opioid Management invites the submission of original papers, research articles, case studies, literature reviews and expert analysis for this special issue.
Our goal is to create an authoritative special issue of JOM that presents the latest research on the basic science, clinical application and public policy aspects of buprenorphine. This issue will address the most important issues opioid prescribers face while utilizing this drug in their practice.
We are seeking papers on the following topics:
· Clinical application of buprenorphine in pain management
· Where does buprenorphine fit on the ladder of analgesics
· Rescheduling of buprenorphine to replace NSAIDS
· How does one rotate onto buprenorphine from other potent opioids
· How does one rotate from buprenorphine to other opioids
· The nuances of buprenorphine PK/PD and its clinical relevance
· Clinical utility of buprenorphine relative to other opioids, safer or not?
· Clinical application of buprenorphine in addiction medicine
· Perioperative management of patients on long term buprenorphine
· Breakthrough pain management on buprenorphine
· What population would likely benefit to using buprenorphine up front
· Buprenorphine in complex persistent opioid dependence
· Buprenorphine in opioid use disorders
· How safe is buprenorphine in organ failure
· Comparison of buprenorphine delivery technologies
· PK/PD of various formulations and delivery platforms
· Suboxone as an analgesic off-label
· Are benzodiazepines OK for a patients on long-term buprenorphine
· Can patients overdose on buprenorphine
· The role of buprenorphine in addressing the opioid crisis
· Economic considerations in prescribing buprenorphine
· Integration of buprenorphine into practice protocols
· Impact of buprenorphine on crime and legal issues
· Legislation impacting buprenorphine adoption
Our goal is to have the special issue ready for publication in late 2020. We are targeting 3,500-6,000 word length articles but longer may be consider with approval from the editor. The special issue will be based on the current JOM article format.
Please submit your manuscript by January 31, 2021 via the manuscript submission link at www.opioidmanagement.com. Contact us with questions at email@example.com or 781-899-2702, ext. 114. We are available to assist you from 9 AM – 4 PM EST
We thank you for your commitment to the proper and adequate use of opioids and your support of this special issue of the Journal of Opioid Management.