Buprenorphine diversion and misuse in outpatient practice

Michelle R. Lofwall, Judith Martin, Matt Tierney, Mélina Fatséas, Marc Auriacombe, Nicholas Lintzeris
Journal of Addiction Medicine. 2014-01-01; 8(5): 327-332
DOI: 10.1097/ADM.0000000000000029

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1. J Addict Med. 2014 Sep-Oct;8(5):327-32. doi: 10.1097/ADM.0000000000000029.

Buprenorphine diversion and misuse in outpatient practice.

Lofwall MR(1), Martin J, Tierney M, Fatséas M, Auriacombe M, Lintzeris N.

Author information:
(1)From the Departments of Behavioral Science and Psychiatry (MRL), Center on
Drug and Alcohol Research, University of Kentucky College of Medicine, Lexington;
Department of Public Health (JM), City and County of San Francisco, San
Francisco, CA; Office-Based Buprenorphine Induction Clinic and Centralized Opiate
Placement Evaluation Clinics (MT), Division of Substance Abuse and Addiction
Medicine, Department of Psychiatry, San Francisco General Hospital, San
Francisco, CA; Université de Bordeaux (Segalen) and Laboratoire de
psychiatrie/SANPSY (MF, MA), CNRS USR 3413, Bordeaux, France, and Département
d’Addictologie (MF, MA), CH Charles Perrens and CHU de Bordeaux, Bordeaux,
France; Drug & Alcohol Services (NL), South East Sydney Local Health District,
Caringbah, New South Wales, Australia; NSW Ministry of Health (NL), Sydney, New
South Wales, Australia; and University of Sydney (NL), Darlington New South
Wales, Australia.

This case is an amalgamation of several real patients in office-based treatment
for prescription opioid dependence synthesized into a single theoretical case.
The case illustrates the various ways in which medication diversion and misuse
may be encountered in clinical practice and therapeutic responses designed to
maximize positive treatment outcomes. It is followed by discussions from several
expert addiction medicine providers from 3 different countries, giving their
perspectives on the salient aspects of this case. This case conference should be
of particular interest to clinicians working with opioid-dependent patients in an
outpatient setting.

DOI: 10.1097/ADM.0000000000000029
PMID: 25221985 [Indexed for MEDLINE]

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