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Review paper

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    Review paper Review paper Document Transcript

    • Buprenorphine as an Alternative Treatment for Drug AddictsAbstractOpioids addiction affects a lot of people every day. Science everyday is looking for new ways totreat these people to get out of this addiction. Methadone has been used for the last forty yearsas the principal treatment for opioids patients. Lately, Buprenorphine is a new treatment that isbeen used and new studies are made to find how efficient is this treatment. This paper presentdifferent studies about how buprenorphine works on patients that were opioids users. Thesestudies look into effects and reactions of the patients when treated with buprenorphine. Most ofthe studies discussed in this paper reported positive results when buprenorphine was used as atreatment even when compared to methadone treatment.Introduction conidine (0.150 mg Catapresan PL ®). This The use of opioids like heroin is was administrated in addiction becausewidely spread. Since the 70’s methadone has many of the patients in the treatment havebeen the treatment used to treat patients that other addictions. For example many of themwant to get out of opioids. Buprenorphine is are alcoholic or smoke to; conidine is aa new drug that has been used to treat these medication use to treat this other kinds ofpatients. Several studies had been made to addictions. Is importance to maintain afind out how effective this drug is. Most of control physiology on the patients for thethe studies discussed in this paper reflect best effect of the treatment. Additionalthat the drug buprenorphine as treatment actions were taken such as, sedatives andworks better than methadone in most cases. psychological support among others.Next, this paper presents the scheme of the Finally, the patients were placed underbuprenorfine treatment, its beneficial effects, psychological treatment, therapeuticssecondary effects, treatment during communities, group therapy among otherspregnancy and after delivery, brain response support groups.to buprenorphine, and a comparison between The reason why these patients startedbuprenorphine and methadone. using opioids varies; also they have differentScheme of the Buprenorphine Treatment habits such as smoking and drinking On a study made in 1994 in the alcohol. Most of the patients in this studySertox where the use of buprenorphine will had different reaction to the treatment. Somebe used as treatment for detoxification of of them needed a second treatment ofpatients with addiction to opioids (AO). Ten buprenorphine and clonodine because theypatients that were treated at Sertox from are needed; only one of them presented totalJanuary 1994 to May 1999 were selected to remission. After six months of the treatmentparticipate in this investigation. A only two patients presented total or partialtherapeutic scheme was developed to treat remission. After the patients finished theirthese patients in this research. The treatment a support treatment must be placedtherapeutic scheme is as follow; initially if not most of these patients will go back tocompress doses of 0.216 mg of opioids. This study concluded that thebuprenorphine were administrated every six pharmalogical properties of buprenorphinehours and was decreasing the doses are accepted by the patients and can be usedgradually by 50% every 48 hours until was as a tool to treat patients addicted to opioids.totally suppressed. At the same timemaintenance for 28 was administrated using
    • Beneficial Effects of Buprenorphine is the patients responses to the need of opiod But the effects on a drug against use. In the same study other patientsanother drug can be beneficial or can harm presented decreased respiratory rate andthe receptor. The benefits of buprenorphine drowsiness. Also is shown that when thecompared to the effects of opiod are shown dose is doubled the patient can present athrough different studies. In a study made by close-dependent increase in analgesia.Sacerdote et al. (2008) they found that the Analgesia is a condition denominated as theuse of opiod such as morphine and heroin absence of feel of pain in the body and manycan make changes in the immune system of times uncontiosness. In this study was founda person. On the contrary, methadone and that the use of buprenorphine in somebuprenorphine can restore the immune patients can have a deficient in salivationfunction and cytokine concentration. but normal saline was used to overcome thisCytokine is a molecule that is secreted by problem. This study does not show any otherthe cells in the immune system; this major secondary effects on patients the usemolecule helps to regulate the body. In a of buprenorphine on patients understudy made by Kapadia et al. (2005) and treatment.cited by Sacerdote et al. (2008) was foundthat a long lasting treatment with methadone Buprenorphine Treatment Duringand buprenorphine normalized the HPA axis Pregnancy and After Deliveringwhen altered when using heroin. The HPAaxis is part of the hypothalamus which is Pregnancy is a time were women arelocated in the brain; this part of the brain is susceptible to put the fetus in danger duringresponsible for the communication between the use of any medicine. Any treatment mustthe nervous system and the endocrine be supervised by a doctor that could offersystem. Many times this communication is the best medication for that mother anddamage because of drug abuse. Another child. Instead the use of a drug likestudy made by Mei et al. (2010) presented buprenorphine during and after the birth of athat a patient using buprenorphine as child can be an alternative for opioidtreatment shows a reduce withdrawal and patients. Most of the time the use ofcraving for heroin. In addition, alleviates methadone has been the treatment preferrednegative reinforcement such as abstinence by physicians but has been found thatand heroin-related cues. This shows that the buprenorphine treatment is less harmful fortreatment of heroin addiction has it benefits the mother and the child. According towhen buprenorphine is used. Martin (2006) has been found that a treatment with buprenorphine duringSecondary Effects of Buprenorphine pregnancy shows better results when using Most of the drugs used to treat any methadone. Martin (2006) mentions that thatkind of illness have secondary effects. When half of the newborns show withdrawal afterbuprenorphine is used on patients that are 72 hours after birth when usingunder a treatment of opioids such as heroin buprenorphine. When women are treatedand as treatment of post operatory patient. with buprenorphine there is no evidenceOn a research by Johnson et al. (2005) they showing that breastfeeding harms the baby,found that after the treatment using since buprenorphine has poorbuprenorphine most of the patients bioavailability. Martin (2006) mentions thatpresented nausea/vomiting and dizziness. a woman that is treated with buprenorphineThis symptoms seem to be normal because it during pregnancy a effort should be done to prevent withdrawal. This is accomplished by
    • giving the mother an appropriate dose methadone as a treatment is because theirduring pregnancy. previous experience with the drug. Pinto says that patients that have been using opioid for a long period of time had better results when using methadone thanBrain Response to Buprenorphine buprenorphine. Although the study made by Through history science has move Pinto et al. (2010) proved that the patientsforward greatly. Technology has been a tool that were under buprenorphine achievedthat science had used to help their cause. sustained abstinence that those participantsThe inclusion of scans to see how the brain using methadone. In addition, the patientsreacts in certain conditions has helped using methadone complained about morescience to help its patients. A study made by side effect that those using buprenorphine.Mei et al. (2010) presented how the brain Pinto et al. (2010) explained that the patientsreacts when using heroin and buprenorphine using methadone had side effects such as;using a MRI. This study showed a constipation, sweating, and sedation.diminution of craving in 5 minutes when Otherwise, the patients using buprenorphineusing buprenorphine. In addition, the MRI showed sedation and constipation as a sidepresented clear images of the brain resulting effect. This study presented that thein objective images. According to Mei the treatment of buprenorphine has better resultsscans illustrated that there were changes in than a treatment with methadone.the brain reaction comparing the early stageswith the later stages of the study. Thismeans that buprenorphine was working and Conclusionthe evidence was clear during the scanningprocess. The use of a MRI gave these Finally, the use of a new drug likeresearchers the opportunity to see how the buprenorphine to treat people that usedifferent parts of the brain react to heroin opioids it is a new alternative that couldand buprenorphine; also they were able to work better for some patients thatcompare those results. Mei compared its methadone does not show positive results.study with the study made Langleden et al. As shown through this paper buprenorphine(2008), cited in this article, both studies is a real alternative for those patients that arefound similar results. trying to start a new life without a dependency of opioids such as heroin. As Sacerdote (2008) pointed out that the treatment of methadone and buprenorphineComparing Buprenorphine with does not assure a good life style for thoseMethadone patients, but at least they seen to show a Starting around the 1970’s good recovery of their immune system.methadone has been the preferred treatment Although, one of the motivations is to give afor heroin patients. Otherwise 52% of the better life style to those patients this aspecthealthcare providers view methadone must be worked out by the patient and itstreatment negatively, stills the preferred one. support group. The best alternative isn’t toIf compared to buprenorphine that has only start to use opioids products, this is17% negative review, this is according to destroying people and families’ everydayPinto et al. (2010). Most of the healthcare and most of them never recover from thisprofessional agrees that the reason they use addiction. Buprenorphine offers to science a
    • new tool to treat drug addicts and as thestudies presented a safer treatment. ReferencesHayley Pinto, Vivienne Maskrey, Louise Swift, Daphne Rumball, Ajay Wagle, Richard Holland.2010. The SUMMIT Trial:A field comparison of buprenorphine versus methadonemaintenance treatment. Available from Journal of Substance Abuse Treatment. July 2010.Judith Martin. 2006. Pregnancy and buprenorphine treatment. Available from PCSS Guidance athttp://www.naabt.org/documents/PCSSPregnancy.pdfLaurence Simmat-Durand, Claude Lejeune, Laurent Gourarier. 2009. 119-123: Pregnancy underhigh-dose buprenorphine. Available from European Journal of Obstetrics & Gynecology andReproductive Biology 142.Paola Sacerdote, Silvia Franchi, Gilberto Gerra, Vincenzo Leccese,Alberto E. Panerai, Lorenzo Somaini. 2008. 606-613:Buprenorphine and methadonemaintenance treatment of heroin addicts preserves immune function. Available fromwww.sciencedirect.comRolley E. Johnson, Paul J. Fudala, and Richard Payne. 2005. 297-326: Buprenorphine:Considerations for Pain Management. Available from Journal of Pain and SymptomManagement. Vol. 9 No. 3 March 2005.W. Mei, J. X. Zhang, and Z. Xiao. 2010. 808-815: Acute Effects of Sublingual buprenorphineon brain responses to heroin-related cues in early-abstinence heroin addicts: an uncontrolled trial.Available from Neuroscience 170 (2010).