Review article. Buprenorphine in the workers' compensation setting
DOI:
https://doi.org/10.5055/jom.2014.0215Keywords:
buprenorphine, workers' compensation, chronic pain, opioid dependenceAbstract
Buprenorphine is approved by the Food and Drug Administration for the treatment of chronic pain in low-dose transdermal patch formulations and for the treatment of addiction in high-dose sublingual tablets and films. Clinicians often prescribe these high-dose preparations “off label” for pain management. In the workers' compensation setting, it is particularly important to consider factors such as a) if the injured person has, and is being treated for co-occurring addiction as well as pain; b) if alternative therapies, including opioid withdrawal, were considered prior to initiating buprenorphine treatment; and c) the anticipated duration of treatment. This article reviews buprenorphine's approved indications, formulations, pharmacology, clinical efficacy, and special considerations in the workers' compensation setting.
References
Purdue Pharma L.P.: Butrans Prescribing Information. 2013. Available at http:/butrans.com. Accessed October 10, 2013.
Pergolizzi J, Aloisi AM, Dahan A, et al.: Current knowledge of buprenorphine and its unique pharmacological profile. Pain Pract. 2010; 10(5): 428-450. DOI: https://doi.org/10.1111/j.1533-2500.2010.00378.x
Huang P, Kehner GB, Cowan A, et al.: Comparison of pharmacological activities of buprenorphine and norbuprenorphine: Norbuprenorphine is a potent opioid agonist. J Pharmacol Exp Ther. 2001; 297(2): 688-695.
Center for Substance Abuse Treatment: Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2004. Treatment Improvement Protocol (TIP) Series, No. 40. 2 Pharmacology. Available at http://www.ncbi.nlm.nih.gov/books/NBK64236. Accessed October 10, 2013.
Whelan PJ, Remski K: Buprenorphine vs methadone treatment: A review of evidence in both developed and developing worlds. J Neurosci Rural Pract. 2012; 3(1): 45-50. DOI: https://doi.org/10.4103/0976-3147.91934
IMS Health: Top 100 Drugs for 2012. Available at http://www.drugs.com/stats/top100/2012/q1/sales. Accessed October 12, 2013.
Reckitt Benckiser Pharmaceuticals: Suboxone Film Dosing Guidance. Available at http://www.suboxone.com/content/pdfs/SuboxonePI.pdf. Accessed October 12, 2013.
Orexo US: Zubsolv Prescribing Information. Available at http://www.zubsolv.com/pdf/zubsolvFullPI-patient.pdf#1. Accessed November 26, 2013.
Suboxone: Amazing detox tool monster maintenance drug. Available at http://guineveregetssober.com/suboxone-amazingdetox-tool-monster-maintenance-drug/. Accessed October 11, 2013.
Suboxone taper. Available at http://suboxonetaper.com/suboxone-taper/. Accessed October 11, 2013.
Suboxone friend or foe? Available at http://serenityhelp.com/addiction-information/suboxone-friend-or-foe/. Accessed October 11, 2013.
Knoff A: Field debates pros and cons of Suboxone taper using film. Available at http://www.alcoholismdrugabuseweekly.com/Article-Detail/field-debates-pros-and-cons-of-suboxonetaper-using-film.aspx. Accessed October 11, 2013.
New Mexico Behavioral Health Collaborative: New Mexico Treatment Guidelines for Medical Providers Who Treat Opioid Addiction Using Buprenorphine. 2012. Available at http://www.bhc.state.nm.us/pdf/NMbuprenorphinetreatguidelinesAug12.pdf. Accessed October 15, 2013.
Weiss RD, Potter JS, Fiellin DA, et al.: Adjunctive counseling during brief and extended buprenorphine-naloxone treatment for prescription opioid dependence: A 2-phase randomized controlled trial. Arch Gen Psychiatry. 2011; 68(12): 1238-1246. DOI: https://doi.org/10.1001/archgenpsychiatry.2011.121
Hamza H, Bryson EO: Buprenorphine maintenance therapy in opioid-addicted health care professionals returning to clinical practice: A hidden controversy. Mayo Clin Proc. 2012; 87(3): 260-267. DOI: https://doi.org/10.1016/j.mayocp.2011.09.007
DuPont RL, McLellan AT, Carr G, et al.: How are addicted physicians treated?: A national survey of Physician Health Programs. J Subst Abuse Treat. 2009; 37(1): 1-7. DOI: https://doi.org/10.1016/j.jsat.2009.03.010
McLellan AT, Skipper GS, Campbell M, et al.: Five year outcomes in a cohort study of physicians treated for substance use disorders in the United States. BMJ. 2008; 337: a2038. DOI: https://doi.org/10.1136/bmj.a2038
McPherson ML: Demystifying Opioid Conversion Calculations: A Guide to Effective Dosing. Bethesda, MD: American Society of Health-System Pharmacists, 2011: 200 pp (softbound, ISBN: 9781585281985).
Cowan A: Buprenorphine: The basic pharmacology revisited. J Addict Med. 2007; 1(2): 68-72. DOI: https://doi.org/10.1097/ADM.0b013e31806c9202
Greenwald MK, Johanson CE, Moody DE, et al.: Effects of buprenorphine maintenance dose on μ-opioid receptor availability, plasma concentrations, and antagonist blockade in heroin-dependent volunteers. Neuropsychopharmacology. 2003; 28: 2000-2009. DOI: https://doi.org/10.1038/sj.npp.1300251
Rosen K, Gutierrez A, Haller D, et al.: Sublingual buprenorphine for chronic pain: A survey of clinician prescribing practices. Clin J Pain. 2014; 30(4): 295-300. DOI: https://doi.org/10.1097/AJP.0b013e318298ddad
Chaparro LE, Furlan AD, Deshpande A, et al.: Opioids compared to placebo or other treatments for chronic low-back pain. Cochrane Database Syst Rev. 2013; 8: CD004959. DOI: https://doi.org/10.1002/14651858.CD004959.pub4
Dana T: Long-Acting Opioid Analgesics Single Drug Addendum: Transdermal Tuprenorphine (Butrans). Pacific Northwest Evidence-based Practice Center. Oregon Health & Science University.
Malinoff HL, Barkin RL, Wilson G: Sublingual buprenorphine is effective in the treatment of chronic pain syndrome. Am J Ther. 2005; 12(5): 379-384. DOI: https://doi.org/10.1097/01.mjt.0000160935.62883.ff
Roux P, Sullivan MA, Cohen J, et al.: Buprenorphine/naloxone as a promising therapeutic option for opioid abusing patients with chronic pain: Reduction of pain, opioid withdrawal symptoms, and abuse liability of oral oxycodone. Pain. 2013; 154(8): 1442-1448. DOI: https://doi.org/10.1016/j.pain.2013.05.004
Neumann AM, Blondell RD, Jaanimägi U, et al.: A preliminary study comparing methadone and buprenorphine in patients with chronic pain and coexistent opioid addiction. J Addict Dis. 2013; 32(1): 68-78. DOI: https://doi.org/10.1080/10550887.2012.759872
Daitch J, Frey ME, Silver D, et al.: Conversion of chronic pain patients from full-opioid agonists to sublingual buprenorphine. Pain Physician. 2012; 15(3 Suppl): ES59-ES66. DOI: https://doi.org/10.36076/ppj.2012/15/ES59
Jones JD, Sullivan MA, Manubay J, et al.: The subjective, reinforcing, and analgesic effects of oxycodone in patients with chronic, non-malignant pain who are maintained on sublingual buprenorphine/naloxone. Neuropsychopharmacology. 2011; 36(2): 411-422. DOI: https://doi.org/10.1038/npp.2010.172
Bohnert AS, Valenstein M, Bair MJ, et al.: Association between opioid prescribing patterns and opioid overdoserelated deaths. JAMA. 2011; 305: 1315-1321. DOI: https://doi.org/10.1001/jama.2011.370
Dunn KM, Saunders KW, Rutter CM, et al.: Opioid prescriptions for chronic pain and overdose: A cohort study. Ann Intern Med. 2010; 152: 85-92. DOI: https://doi.org/10.7326/0003-4819-152-2-201001190-00006
Gomes T, Mamdani MM, Dhalla IA, et al.: Opioid dose and drug-related mortality in patients with nonmalignant pain. Arch Intern Med. 2011; 171: 686-691. DOI: https://doi.org/10.1001/archinternmed.2011.117
Chou R, Fanciullo GJ, Fine PG, et al.: American Pain Society-American Academy of Pain Medicine Opioids Guidelines Panel. Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain. 2009; 10(2): 113-130. DOI: https://doi.org/10.1016/j.jpain.2008.10.008
Federation of State Medical Boards: Model policy for the use of controlled substances for the treatment of pain. J Pain Palliat Care Pharmacother. 2004; 19: 73-78. DOI: https://doi.org/10.1080/J354v19n02_14
Washington State Department of Labor and Industries: Guideline for Prescribing Opioids to Treat Pain in Injured Workers. 2013. Available at http://www.lni.wa.gov/ClaimsIns/Providers/TreatingPatients/ByCondition/Opioids/default.asp. Accessed November 26, 2013.
Baron MJ, McDonald PW: Significant pain reduction in chronic pain patients after detoxification from high-dose opioids. J Opioid Manag. 2006; 2(5): 277-282. DOI: https://doi.org/10.5055/jom.2006.0041
Rome JD, Townsend CO, Bruce BK, et al.: Chronic noncancer pain rehabilitation with opioid withdrawal: Comparison of treatment outcomes based on opioid use status at admission. Mayo Clin Proc. 2004; 79(6): 759-768. DOI: https://doi.org/10.1016/S0025-6196(11)62628-1
Townsend CO, Kerkvliet JL, Bruce BK, et al.: A longitudinal study of the efficacy of a comprehensive pain rehabilitation program with opioid withdrawal: Comparison of treatment outcomes based on opioid use status at admission. Am J Phys Med Rehabil. 2008; 87(7): 527-536. DOI: https://doi.org/10.1016/j.pain.2008.08.005
Crisostomo RA, Schmidt JE, Hooten WM, et al.: Withdrawal of analgesic medication for chronic low-back pain patients: Improvement in outcomes of multidisciplinary rehabilitation regardless of surgical history. Am J Phys Med Rehabil. 2008; 87(7): 527-536. DOI: https://doi.org/10.1097/PHM.0b013e31817c124f
Published
How to Cite
Issue
Section
License
Copyright 2005-2024, Weston Medical Publishing, LLC
All Rights Reserved