OBJECTIVES To review current evidence on buprenorphine-naloxone (bup/nx) for the treatment of opioid-use disorders, with a focus on strategies for clinical management and office-based patient care. QUALITY OF EVIDENCE Medline and the Cochrane Database of Systematic Reviews were searched. Consensus reports, guidelines published, and other authoritative sources were also included in this review...

There is now compelling evidence that harm reduction approaches to HIV prevention among injecting drug users are effective, safe and cost-effective. The evidence of effectiveness is strongest for needle and syringe programs and opioid substitution treatment. There is no convincing evidence that needle and syringe programs increase injecting drug use. The low prevalence approximately 1%) of HIV ...

The evaluation of the outcome of the pilot Opioid Substitution Therapy programme in Penitentiary Institution No. 47 in Bishkek (Kyrgyzstan) took place in 2009–2010. The programme’s participants consisted of 84 patients enrolled in methadone maintenance therapy. Assessments were carried out at baseline and after 3 and 6 months. Instruments adopted by WHO, translated into Russian and applied in e...

BACKGROUND Crack cocaine use is known to contribute to poor adherence to antiretroviral medications; however, little is known about facilitators of or barriers to effective HIV treatment use among HIV-infected crack cocaine users. We sought to identify correlates of optimal pharmacy refill adherence for antiretroviral medications and plasma HIV RNA viral load (pVL) suppression among this popula...

BACKGROUND Addiction to opioids, or opioid dependence, encompasses the biopsychosocial dysfunction seen in illicit heroin injectors, as well as aberrant behaviours in patients prescribed opioids for chronic nonmalignant pain. OBJECTIVE To outline the management of opioid dependence using opioid pharmacotherapy as part of a comprehensive chronic illness management strategy. DISCUSSION The sa...

Medication-assisted treatment of opioid use disorder with physiological dependence at least doubles rates of opioid-abstinence outcomes in randomized, controlled trials comparing psychosocial treatment of opioid use disorder with medication versus with placebo or no medication. This article reviews the current evidence for medication-assisted treatment of opioid use disorder and also presents c...

INTRODUCTION Opioid dependence is recorded as the most common drug of abuse in Malaysia. Currently, the preferred substitution therapy for most Government treatment centres is methadone used as substitution therapy for opioid dependence. There are, however patients who may benefit from being on the combined buprenorphine-naloxone formulation as substitution therapy instead. We discuss six cases...

AIMS To examine concurrent buprenorphine and benzodiazepine consumption and to compare opioid toxicity symptoms induced by methadone and buprenorphine, examining factors associated with the reporting of these symptoms. DESIGN Self-report cross-sectional survey. SETTING Five needle syringe programmes and five opioid substitution treatment services in Melbourne, Australia. PARTICIPANTS A to...