What Do You Recommend When Patients Continue For Relapse While Taking Buprenorphine?
I recognize that opioid addiction is an illness, so I increase the intensity of treatment if a patient should relapse. However, repeated relapses signify a major problem. Medication-assisted treatment with buprenorphine requires a great deal of self-monitoring (self-policing). Patients who are unable to self-monitor are still in need of treatment, but at a higher intensity level. Options include treatment at an Opioid Treatment Program (methadone maintenance clinic) or Rehabilitation. We do not abandon the patient.
Will treatment with buprenorphine continue?
I believe so, but there are concerns. The DEA is now reporting increased abuse of buprenorphine through buying, selling, and trading on the street. Arrests for the purchase and sale of buprenorphine on the street are on the rise, jeopardizing access to the medication to those who truly need it.
If the DEA decides that abuse of buprenorphine overrides its benefits, they could change the buprenorphine schedule from a Schedule 3 to a Schedule 2, effectively ending office-based medication-assisted treatment with buprenorphine. The DEA made a similar change for all hydrocodone formulations in 2014, moving them from Schedule 3 to Schedule 2.
The goal is to expand treatment, not curtail it.
What is the best way to dispose of unused painkillers?
Unused opioids increase the risk of accidental overdose and diversion, especially for younger…