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Date of Award
Spring 2021
Degree Name
Master of Medical Science (Physician Assistant)
Department
Physician Assistant; College of Health Sciences
First Advisor
ToriAnne Yetter
Abstract
Introduction: Over the past 20 years in the United States, there has been an increase in individuals who are dependent upon prescription, illicit, and synthetic opioids. Opioid use disorder is a chronic and often relapsing illness that has a huge economic impact and leads to negative social, emotional, and health consequences. Buprenorphine/naloxone is a medication that is approved for the treatment of OUD, can be dispensed by a primary care physician, and has a lower potential for abuse and respiratory depression than Methadone.
Methods: A literature search was performed in November 2019 utilizing Pubmed and EBSCO. Articles were selected if they were relevant to the research question, published in the last 10 years, and were based on clinical trials. In addition to the criteria previously mentioned, articles that directly compared heroin only users and prescription opioid only users were selected then “similar articles” was selected.
Results: Many of the studies found that prescription opioid only users had better outcomes than heroin only users or combined users. Dosage of buprenorphine varied throughout the studies and some of the authors suggested that higher doses were necessary for heroin only users, those with severe drug use habits or those with severe withdrawal symptoms. For hospitalized subjects, providing linkage to outpatient treatment centers that provide buprenorphine treatment resulted in a higher percentage entering treatment upon discharge. Long term buprenorphine treatment also resulted in better outcomes.
Discussion: The results of the studies showed better outcomes for prescription opioid only users. Each of the seven studies showed significant differences in at least one of the outcome measures used between heroin only users and prescription opioid only users receiving buprenorphine/naloxone therapy
Conclusion: The results of the research in the studies analyzed can be used to guide providers when making treatment decisions but their clinical judgement is still necessary in order to select the best treatment for patient with various presentations of OUD. There is not enough evidence to call for a change in practice.
Recommended Citation
Mansueti, Kathryn, "Treatment Outcomes of Buprenorphine/Naloxone When Comparing Individuals with Heroin Only Opioid Use Disorder and Individuals with Prescription Opioid Only Opioid Use Disorder" (2021). Capstone Showcase. 61.
https://scholarworks.arcadia.edu/showcase/2021/pa/61
Treatment Outcomes of Buprenorphine/Naloxone When Comparing Individuals with Heroin Only Opioid Use Disorder and Individuals with Prescription Opioid Only Opioid Use Disorder
Introduction: Over the past 20 years in the United States, there has been an increase in individuals who are dependent upon prescription, illicit, and synthetic opioids. Opioid use disorder is a chronic and often relapsing illness that has a huge economic impact and leads to negative social, emotional, and health consequences. Buprenorphine/naloxone is a medication that is approved for the treatment of OUD, can be dispensed by a primary care physician, and has a lower potential for abuse and respiratory depression than Methadone.
Methods: A literature search was performed in November 2019 utilizing Pubmed and EBSCO. Articles were selected if they were relevant to the research question, published in the last 10 years, and were based on clinical trials. In addition to the criteria previously mentioned, articles that directly compared heroin only users and prescription opioid only users were selected then “similar articles” was selected.
Results: Many of the studies found that prescription opioid only users had better outcomes than heroin only users or combined users. Dosage of buprenorphine varied throughout the studies and some of the authors suggested that higher doses were necessary for heroin only users, those with severe drug use habits or those with severe withdrawal symptoms. For hospitalized subjects, providing linkage to outpatient treatment centers that provide buprenorphine treatment resulted in a higher percentage entering treatment upon discharge. Long term buprenorphine treatment also resulted in better outcomes.
Discussion: The results of the studies showed better outcomes for prescription opioid only users. Each of the seven studies showed significant differences in at least one of the outcome measures used between heroin only users and prescription opioid only users receiving buprenorphine/naloxone therapy
Conclusion: The results of the research in the studies analyzed can be used to guide providers when making treatment decisions but their clinical judgement is still necessary in order to select the best treatment for patient with various presentations of OUD. There is not enough evidence to call for a change in practice.