Abstract
Do We Really Need to Continue Pharmacotherapy for Opioid Use Disorder (OUD) Indefinitely?
Highlights
After introduction of buprenorphine and buprenorphine/naloxone combination (BUP) in the US in 2002, pharmacological treatment of opioid use disorder (OUD) has become more popular and accessible because it can be dispensed/prescribed in the office and individuals have to visit the clinic only once in several weeks
It is unclear whether pharmacotherapy for opioid use disorder (OUD) should be continued for short or long-term
Methadone was the primary pharmacotherapy for OUD in the United States
Summary
After introduction of buprenorphine and buprenorphine/naloxone combination (BUP) in the US in 2002, pharmacological treatment of opioid use disorder (OUD) has become more popular and accessible because it can be dispensed/prescribed in the office and individuals have to visit the clinic only once in several weeks This is a departure from methadone treatment protocol, which requires patients to report to the clinic on a daily basis. It downregulates μ receptors in several brain areas (frontal cortex, parietal cortex, thalamus, hippocampus, striatum, brain stem) and upregulate κ 1 receptors in the striatum and frontal, parietal, and occipital cortex It is not yet known whether long-term use of BUP will have the same adverse effects that are associated with long-term use of opioids.
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