Buprenorphine – The ideal drug for most clinical indications for an opioid?

Buprenorphine – The ideal drug for most clinical indications for an opioid? In this issue of the Scandinavian Journal of Pain, Stephen Butler, former chief of the famous Bonica Pain Clinic at the University of Washington in Seattle, reviews new knowledge of buprenorphine [1]. During the four decades after buprenorphine became available for clinical use persistent misunderstandings have existed in textbooks and in reviews in medical literature. These misunderstandings have misled clinicians and patients so that optimal uses of this drug were reduced. This problem continues to this day [1].The first serious misunderstanding was that buprenorphine is not an addicting drug. It was marketed as a drug for moderate to severe pain with low risk of misuse or abuse. Clinicians and addicted persons soon discovered that this is not true. I was surprised and very disappointed to discover soon after the sublingual buprenorphine was available in Norway, already in 1983–84, that one of my patients sold his sublingual buprenorphine tablets on the illegal market. Addicted persons dissolved the sublingual tablets and injected the drug. So buprenorphine was soon moved on to the narcotic drug list.There are other misunderstandings about buprenorphine, mostly based on animal data. These misunderstandings came into textbooks on pharmacology and pain as “medical truths” about 30 years ago. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Scandinavian Journal of Pain de Gruyter

Buprenorphine – The ideal drug for most clinical indications for an opioid?

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Publisher
De Gruyter
Copyright
© 2013 Scandinavian Association for the Study of Pain
ISSN
1877-8860
eISSN
1877-8879
D.O.I.
10.1016/j.sjpain.2013.05.005
Publisher site
See Article on Publisher Site

Abstract

In this issue of the Scandinavian Journal of Pain, Stephen Butler, former chief of the famous Bonica Pain Clinic at the University of Washington in Seattle, reviews new knowledge of buprenorphine [1]. During the four decades after buprenorphine became available for clinical use persistent misunderstandings have existed in textbooks and in reviews in medical literature. These misunderstandings have misled clinicians and patients so that optimal uses of this drug were reduced. This problem continues to this day [1].The first serious misunderstanding was that buprenorphine is not an addicting drug. It was marketed as a drug for moderate to severe pain with low risk of misuse or abuse. Clinicians and addicted persons soon discovered that this is not true. I was surprised and very disappointed to discover soon after the sublingual buprenorphine was available in Norway, already in 1983–84, that one of my patients sold his sublingual buprenorphine tablets on the illegal market. Addicted persons dissolved the sublingual tablets and injected the drug. So buprenorphine was soon moved on to the narcotic drug list.There are other misunderstandings about buprenorphine, mostly based on animal data. These misunderstandings came into textbooks on pharmacology and pain as “medical truths” about 30 years ago.

Journal

Scandinavian Journal of Painde Gruyter

Published: Dec 29, 2017

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