Recommendations for buprenorphine and methadone therapy in opioid use disorder: a European consensus

Maurice Dematteis, Marc Auriacombe, Oscar D’Agnone, Lorenzo Somaini, Néstor Szerman, Richard Littlewood, Farrukh Alam, Hannu Alho, Amine Benyamina, Julio Bobes, Jean Pierre Daulouede, Claudio Leonardi, Icro Maremmani, Marta Torrens, Stephan Walcher, Michael Soyka
Expert Opinion on Pharmacotherapy. 2017-12-03; 18(18): 1987-1999
DOI: 10.1080/14656566.2017.1409722

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Dematteis M(1)(2), Auriacombe M(3)(4)(5), D’Agnone O(6), Somaini L(7), Szerman N(8), Littlewood R(9), Alam F(10), Alho H(11), Benyamina A(12), Bobes J(13), Daulouede JP(3)(4)(14), Leonardi C(15), Maremmani I(16), Torrens M(17), Walcher S(18), Soyka M(19)(20).

Author information:
(1)a Department of Addiction Medicine , Grenoble Alpes University Hospital , Grenoble , France.
(2)b Faculty of Medicine , Grenoble Alpes University , Grenoble , France.
(3)c Université de Bordeaux , Bordeaux , France.
(4)d Addiction Psychiatry Team , SANPsy CNRS USR , Bordeaux , France.
(5)e Pôle Addictologie, CH Ch. Perrens and CHU Bordeaux , Bordeaux , France.
(6)f Faculty of Medical and Human Sciences , Institute of Brain Behaviour and
Mental Health, University of Manchester , Manchester , UK.
(7)g Addiction Treatment Centre , Biella , Italy.
(8)h Department of Psychiatry , Hospital Universitario Gregorio Marañon , Madrid, Spain.
(9)i Applied strategic , London , UK.
(10)j Divisional Medical Director, Central & North West London NHS Foundation Trust , London , UK.
(11)k Abdominal Center , University Hospital and University of Helsinki , Helsinki , Finland.
(12)l Centre d’Enseignement, de Recherche et de Traitement des Addictions, AP-HP, Paris-Sud University Hospital Group, Paul Brousse site , Paris-Sud University , Villejuif , France.
(13)m Department of Psychiatry , University of Oviedo-CIBERSAM , Oviedo , Spain.
(14)n Centre d׳Addictologie, BIZIA and CH Bayonne , Bayonne , France.
(15)o Drug Addiction Department , Local Public Health ASL Rome 2 , Rome , Italy.
(16)p Santa Chiara University Hospital , University of Pisa , Pisa , Italy.
(17)q Department of Psychiatry and Legal Medicine , Universidad Autonoma de Barcelona, Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institut) , Barcelona , Spain.
(18)r CONCEPT, Addiction Medicine , Munich , Germany.
(19)s Department of Psychiatry , Ludwig Maximilian University , Munich , Germany.
(20)t Medical Park Ciemseeblick , Bernau-Felden , Germany.

INTRODUCTION: Management of patients with opioid use disorder (OUD) commonly
includes opioid agonist therapy (OAT) as a part of an integrated treatment plan.
These interventions are associated with proven benefits to the individual and
society. Areas covered: The use of methadone and buprenorphine within an
integrated treatment plan in the management of patients with OUD: this work
provides consensus recommendation on pharmacotherapy in OUD to assist clinicians
with practical decision making in this field. Expert opinion: Pharmacotherapy is
recommended as part of an integrated OUD treatment approach with psychosocial
interventions, with the goal of reducing risks of illicit opioid use, overdose
mortality, infection with HIV or HCV, improving health, psychological and social
outcomes. Access to OAT should be prioritised in the treatment of OUD. Treatment
choices in OUD pharmacotherapy should be based on the needs of the individual and
characteristics of medications. Recommendations for choices of OAT are based on
clinical efficacy, safety, patient preference, side effects, pharmacological
interactions, quality of life, dose titration potential and outcomes (control
craving, ongoing opioids consumption or other drugs, and potentially psychiatric
comorbidities). Special groups, pregnant women, prisoners, patients with mental
health problems have specific needs which must be addressed with expert input.

DOI: 10.1080/14656566.2017.1409722
PMID: 29183228 [Indexed for MEDLINE]

Auteurs Bordeaux Neurocampus