Medication-Assisted Treatment in the Perianesthesia Setting

Abstract

IN 2015, one in 10 Americans (27 million) ages 12 or older used an illicit drug in the past month, and opioid pain relievers were the second most commonly used drug (3.8 million). 1 Center for Behavioral Health Statistics and QualityKey Substance Use and Mental Health Indicators in the United States: Results From the 2015 National Survey on Drug Use and Health. 2016https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2015/NSDUH-FFR1-2015/NSDUH-FFR1-2015.htm Google Scholar Current trends in opiate morbidity and mortality include increased use of heroin and illicit synthetic fentanyl. 2 Centers for Disease Control and PreventionHeroin Overdose Data. 2017https://www.cdc.gov/drugoverdose/data/heroin.html Google Scholar , 3 Gladden R.M. Martinez P. Seth P. Fentanyl law enforcement submissions and increases in synthetic opioid-involved overdose deaths - 27 States, 2013-2014. MMWR Morbidity Mortality Weekly Rep. 2016; 65: 837-843 Crossref PubMed Scopus (286) Google Scholar More than 2 million people with a substance use disorder that included pain relievers (opioids) sought treatment in 2015. 1 Center for Behavioral Health Statistics and QualityKey Substance Use and Mental Health Indicators in the United States: Results From the 2015 National Survey on Drug Use and Health. 2016https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2015/NSDUH-FFR1-2015/NSDUH-FFR1-2015.htm Google Scholar Treatment of opioid use disorder (OUD) may include the use of medications such as methadone, buprenorphine, and naltrexone. The use of these substances to treat OUD is referred to as medication-assisted treatment (MAT). In 2011, about 300,000 people received methadone in opioid treatment programs and more than 32,000 individuals were treated with buprenorphine. 4 Alderks C.E. Trends in the Use of Methadone and Buprenorphine at Substance Abuse Treatment Facilities: 2003 to 2011. The CBHSQ Report. Substance Abuse and Mental Health Services Administration (US), Rockville (MD)2013 Google Scholar Because of recent legislation, nurse practitioners and physician assistants are able to prescribe buprenorphine as part of MAT, 5 American Society of Addiction MedicineSummary of the Comprehensive Addiction and Recovery Act. 2016http://www.asam.org/advocacy/issues/opioids/summary-of-the-comprehensive-addiction-and-recovery-act Google Scholar so the number of individuals receiving buprenorphine is expected to grow. Naltrexone is another emerging treatment option for OUD that may be effective for other types of addiction such as alcohol use disorder. 6 Aboujaoude E. Salame W.O. Naltrexone: A pan-addiction treatment?. CNS Drugs. 2016; 30: 719-733 Crossref PubMed Scopus (41) Google Scholar Kathleen Broglio, DNP, ANP-BC, Palliative Care, Dartmouth Hitchcock Medical Center, Lebanon, NH Maureen F. Cooney, DNP, FNP-BC, Pain Management, Westchester Medical Center, Valhalla, NY