Abstract
Pharmacotherapy is the mainstay and standard of care for treatment of opioid use disorder with behavioral interventions serving as essential adjunctive treatment. Managing patients with opioid use disorder without medications typically fails with 80–90 % relapse rates described (Ball and Ross. The effectiveness of methadone maintenance treatment: clients, programs, services, and outcome. New York: Springer; 1991; Weiss et al. Arch Gen Psychiatry. 2011;68(12):1238–46). Methadone, a full μ-opioid agonist, and buprenorphine, a μ-opioid partial agonist and κ-opioid antagonist, are two FDA-approved medications for the treatment of opioid use disorder. In this chapter, we will discuss the role of these medications in the treatment of opioid use disorder while describing what data exist on the role of these medications in treatment of patients with co-occurring chronic pain and opioid use disorder.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Saxon AJ. Treatment of opioid dependence. In: Ko M-C, Husbands SM, editors. Research and development of opioid-related ligands. New York: Oxford University Press; 2013. p. 61–102.
Ferrari A, Coccia CP, Bertolini A, Sternieri E. Methadone metabolism, pharmacokinetics and interactions. Pharmacol Res. 2004;50(6):551–9.
Eap CB, Buclin T, Baumann P. Interindividual variability of the clinical pharmacokinetics of methadone: implications for the treatment of opioid dependence. Clin Pharmacokinet. 2002;41(14):1153–93.
Armstrong SC, Cozza KL. Med-psych drug-drug interaction update. Psychosomatics. 2001;42(5):435–7.
Tarumi Y, Pereira J, Watanabe S. Methadone and fluconazole: respiratory depression by drug interaction. J Pain Symptom Mange. 2002;23(2):148–53.
McCance-Katz EF, Sullivan LE, Nallani S. Drug interactions of clinical importance among the opioids, methadone and buprenorphine and other frequently prescribed medications: a review. Am J Addict. 2010;19(1):4–16.
Strain EC, Bigelow GE, Lievson IA, Stilzer ML. Moderate- vs high-dose methadone in the treatment of opioid dependence: a randomized trial. JAMA. 1999;281(11):100–5.
Abuse S, Administration MHS. Managing chronic pain in adults with or in recovery from substance use disorders. HHS publication No. (SMA) 12-4671, Treatment improvement protocol (TIP), vol. 54. Rockville: Substance Abuse and Mental Health Services Administration; 2011.
Eyler E. Chronic and acute pain and pain management for patients in methadone maintenance treatment. Am J Addict. 2013;22:75–83.
Dunn KE, Brooner RK, Clark MR. Severity and interference of chronic pain in methadone-maintained outpatients. Pain Med. 2014;15(9):1540–8.
Neumann AM, Blondell RD, Jaanimagi U, et al. A preliminary study comparing methadone and buprenorphine in patients with chronic pain and co-existent opioid addiction. J Addict Dis. 2013;32(1):68–78.
Blinderman CD, Sekine R, Zhang B, et al. Methadone as an analgesic for patients with chronic pain in methadone maintenance treatment programs (MMTPs). J Opioid Manag. 2009;5:107–14.
Angst MS, Clark DJ. Opioid-induced hyperalgesia: a qualitative systematic review. Anesthesiology. 2006;104:570–87.
Mao J. Opioid-induced abnormal pain sensitivity: implications in clinical opioid therapy. Pain. 2002;100:213–7.
Clark MR, Stoller KB, Brooner RK. Assessment and management of chronic pain in individuals seeking treatment for opioid use disorder. Can J Psychiatry. 2008;53(8):496–508.
Dahan A, Yassen A, Bijl H, Romberg R, Sarton E, Teppema L, et al. Comparison of the respiratory effects of intravenous buprenorphine and fentanyl in humans and rats. Br J Anaesth. 2005.
Walsh SL, Preston KL, Stitzer ML, Cone EJ, Bigelow GE. Clinical pharmacology of buprenorphine: ceiling effect at high doses. Clin Pharmacol Ther. 1994;55(5):569–80.
Chiang CN, Hawks RL. Pharmacokinetics of the combination tablet of buprenorphine and naloxone. Drug Alcohol Depend. 2003;70(2 Suppl):S39–47.
Nath RP, Upton RA, Everhart ET, Cheung P, Shwonek P, Jones RT, et al. Buprenorphine pharmacokinetics: relative bioavailability of sublingual tablet and liquid formulations. J Clin Pharmacol. 1999;39(6):619–23.
Chiou LC, Liao YY, Fan PC, Kuo PH, Wang CH, Riemer C, et al. Nociceptin/orphanin FQ peptide receptors: pharmacology and clinical implications. Curr Drug Targets. 2007;8(1):117–35.
Walsh SL, Eissenberg T. The clinical pharmacology of buprenorphine: extrapolating from the laboratory to the clinic. Drug Alcohl Depend. 2003;70(2 Suppl):S13–27.
Debelak K, Korrone WR, O’Grady KE, Jones HE. Buprenorphine + naloxone in the treatment of opioid dependence during pregnancy—initial patient care and outcome data. Am J Addict. 2013;22(3):252–4.
Bruce RD, Moody DE, Altice FL, Gourevitch MN, Friedland GH. A review of pharmacological interactions between HIV or hepatitis C virus medications and opioid agonist therapy: implications and management for clinical practice. Expert Rev Clin Pharmacol. 2013;6(3):249–69.
McCance-Katz EF, Moody DE, Prathikanti S, Friedland G, Rainey PM. Rifampin, but not rifabutin, may produce opiate withdrawal in burprenorphine-maintained patients. Drug Alcohol Depend. 2011;118(2-3):326–34.
Sanson RA, Sansone LA. Buprenorphine treatment for narcotic addiction: not without risks. Innov Clin Neurosci. 2015;12(3-4):32–6.
Saxon AJ, Ling W, Hillhouse M, Thomas C, Hasson A, Ang A, et al. Buprenorphine/Naloxone and methadone effects on laboratory indices of liver health: a randomized trial. Drug Alcohol Depend. 2013;128(1-2):71–6.
Wesson DR, Ling W. The Clinical Opiate Withdrawal Scale (COWS). J Psychoactive Drugs. 2003;35(2):253–9.
Daitch J, Frey ME, Silver D, Mitnick C, Daitch D, Pergolizzi Jr J. Conversion of chronic pain patients from full-opioid agonists to sublingual buprenorphine. Pain Physician. 2012;15(3 suppl):ES59–66.
Heit HA, Gourlay DL. Buprenorphine: new tricks with an old molecule for pain management. Clin J Pain. 2008;24(2):93–7.
Malinoff HL, Barkin RL, et al. Sublingual buprenorphine is effective in the treatment of chronic pain syndrome. Am J Ther. 2005;12(5):410–8.
Chen K, Chen L, Mao J. Buprenorphine-Naloxone therapy in pain management. Anesthesiology. 2014;120:1262–74.
Pade PA, Cardon KE, et al. Prescription opioid abuse, chronic pain, and primary care: a co-occurring disorders clinic in the chronic disease model. J Subst Abuse Treat. 2012;43:446–50.
Sittl R, Griessinger N, Likar R. Analgesic efficacy and tolerability of transdermal buprenorphine in patients with inadequately controlled chronic pain related to cancer and other disorders: A multicenter, randomized, double-blind, placebo-controlled trial. Clin Ther. 2003;25:150–68.
Gourlay DL, Heit HA. Pain and addiction: managing risk through comprehensive care. J Addict Dis. 2008;27(3):23–30.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Buchholz, J.R., Saxon, A.J. (2016). Methadone and Buprenorphine: The Place of Opiate Replacement Therapies. In: Matthews, A., Fellers, J. (eds) Treating Comorbid Opioid Use Disorder in Chronic Pain. Springer, Cham. https://doi.org/10.1007/978-3-319-29863-4_6
Download citation
DOI: https://doi.org/10.1007/978-3-319-29863-4_6
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-29861-0
Online ISBN: 978-3-319-29863-4
eBook Packages: MedicineMedicine (R0)