Buprenorphine Update and Evolving Standards of Care-View Presentation

Video Transcription

Video Summary

The session, led by Dr. John Renner and team, focused on updates regarding the use and management of buprenorphine, particularly in the context of the opioid crisis marked by fentanyl and xylosine. They highlighted the shift in overdose trends and the minimal increase in buprenorphine prescribing despite the waiver removal by the government. Crucially, they reviewed induction methods for buprenorphine, emphasizing more rapid approaches due to the potency of fentanyl.<br /><br />Furthermore, the session explored various induction techniques including high-dose and micro-dosing, suited to either emergency or outpatient settings, underscoring the need to mitigate the challenge of precipitated withdrawal. They also mentioned medication options for treating opioid use disorder, stressing particularly the need for physicians to build strong relationships with patients, enhancing treatment adherence beyond just medication supply.<br /><br />A significant concern discussed was xylosine, an alpha-2 agonist recently introduced into the drug supply. The impact of xylosine, particularly the severe skin ulcerations and its prevalence in certain regions, was addressed, alongside the inadequacy of naloxone in managing overdoses involving xylosine.<br /><br />Given the evolving landscape of opioid substitutes and antagonist therapy, the team also explored the utility of new formulations in managing acute and chronic pain among patients on buprenorphine. Psychotherapy's significance was reinforced, highlighting the importance of a supportive therapeutic relationship in improving recovery outcomes. The session concluded with insights from attendees, fostering a collaborative learning environment to address contemporary challenges in opioid addiction treatment.

Keywords

buprenorphine

opioid crisis

fentanyl

xylosine

overdose trends

induction methods

high-dose micro-dosing

precipitated withdrawal

opioid use disorder

medication adherence

naloxone inadequacy

psychotherapy

opioid addiction treatment