Articles: narcotic-antagonists.
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Substance use & misuse · Jan 2008
Evaluation of a naloxone distribution and administration program in New York City.
Naloxone, an opiate antagonist that can avert opiate overdose mortality, has only recently been prescribed to drug users in a few jurisdictions (Chicago, Baltimore, New Mexico, New York City, and San Francisco) in the United States. This report summarizes the first systematic evaluation of large-scale naloxone distribution among injection drug users (IDUs) in the United States. In 2005, we conducted an evaluation of a comprehensive overdose prevention and naloxone administration training program in New York City. ⋯ Naloxone was administered 82 times; 68 (83.0%) persons who had naloxone administered to them lived, and the outcome of 14 (17.1%) overdoses was unknown. Ninety-seven of 118 participants (82.2%) said they felt comfortable to very comfortable using naloxone if indicated; 94 of 109 (86.2%) said they would want naloxone administered if overdosing. Naloxone administration by IDUs is feasible as part of a comprehensive overdose prevention strategy and may be a practicable way to reduce overdose deaths on a larger scale.
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Clin. Pharmacol. Ther. · Jan 2008
Randomized Controlled TrialEnhanced buprenorphine analgesia with the addition of ultra-low-dose naloxone in healthy subjects.
Animal studies have demonstrated that co-administration of an ultra-low-dose opioid antagonist with an opioid agonist may result in enhanced analgesia. Investigation of this effect in humans has been limited and produced inconsistent findings, with previous reports suggesting that dose ratio may be critical to analgesic potentiation. ⋯ Importantly, this enhanced analgesia occurred without an increase in adverse effects; indeed at some ratios, respiratory depression was attenuated. These findings demonstrate that the addition of ultra-low-dose naloxone can enhance the analgesic effect of buprenorphine in humans without a concurrent increase in side effects.
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Cochrane Db Syst Rev · Jan 2008
Review Meta AnalysisBuprenorphine maintenance versus placebo or methadone maintenance for opioid dependence.
Buprenorphine has been reported as an alternative to methadone for maintenance treatment of opioid dependence, but differing results are reported concerning its relative effectiveness indicating the need for an integrative review. ⋯ Buprenorphine is an effective intervention for use in the maintenance treatment of heroin dependence, but it is less effective than methadone delivered at adequate dosages.
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Subst Abuse Treat Prev Policy · Jan 2008
Multicenter StudyA retrospective evaluation of patients switched from buprenorphine (Subutex) to the buprenorphine/naloxone combination (Suboxone).
In Finland, buprenorphine (Subutex) is the most abused opioid. In order to curb this problem, many treatment centres transferred ("forced transfer") their buprenorphine patients to the buprenorphine plus naloxone (Suboxone) combination product in late 2003. ⋯ We conclude that when patients are transferred from high doses (> 22 mg) of buprenorphine to the combination product, dose adjustments may be necessary especially in the later phase of the treatment. We recommend that a transfer from Subutex to Suboxone should be carefully discussed and planned in advance with the patients and after the transfer adverse events should be regularly monitored. With regard of buprenorphine IV abuse, the combination product seems to have a less abuse potential than buprenorphine alone.