Articles: narcotic-antagonists.
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Addict Sci Clin Pract · Mar 2019
Provider and patient perspectives on barriers to buprenorphine adherence and the acceptability of video directly observed therapy to enhance adherence.
Buprenorphine effectively reduces opioid craving and illicit opioid use. However, some patients may not take their medication as prescribed and thus experience suboptimal outcomes. The study aim was to qualitatively explore buprenorphine adherence and the acceptability of utilizing video directly observed therapy (VDOT) among patients and their providers in an office-based program. ⋯ Findings suggest potential arenas for enhancing buprenorphine adherence, although structural barriers will likely be most challenging to ameliorate. Providers as well as patients indicated mixed attitudes toward VDOT, suggesting it would need to be thoughtfully implemented.
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Expanding access to medication-assisted treatment with buprenorphine is a cornerstone of the opioid crisis response, yet buprenorphine remains underutilized. Research has identified multiple barriers to prescribing buprenorphine. This study aimed to examine clinician characteristics, prescribing practices and barriers and incentives to prescribing buprenorphine among clinicians with a federal Drug Addiction Treatment Act of 2000 (DATA) waiver to prescribe buprenorphine for opioid use disorder treatment. ⋯ US clinicians recently waivered to prescribe buprenorphine for opioid use disorder treatment appear to prescribe well below their patient limit, and many do not prescribe at all.
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Opioids are increasingly prescribed in the West and have deleterious GI consequences. Pharmacological therapies to treat opioid-induced constipation (OIC) are available, but their relative efficacy is unclear. We performed a systematic review and network meta-analysis to address this deficit in current knowledge. ⋯ In network meta-analysis, naloxone and naldemedine appear to be the most efficacious treatments for OIC. Naloxone was the safest of these agents.