As a result of the prescription opioid epidemic in the United States, there has been an increasing need for effective treatment interventions, both pharmacological and nonpharmacological. Buprenorphine has emerged as a critical component of the treatment of opioid use disorder, yet its adoption has not been without some concerns. This article first reviews the pharmacology, clinical use, and US legislative action related to buprenorphine, followed by a discussion of the misuse and diversion of buprenorphine in the United States as well as internationally. We then explore the impact of buprenorphine abuse as well as discussing strategies for its reduction, including changes in policy, prescription and pharmacy monitoring, and continuing medical education for guiding and improving clinical practice.
LI, SHORTER, and KOSTEN: Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX
SHORTER and KOSTEN: Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX
This material is the result of work supported with resources and the use of facilities at Baylor College of Medicine and the Michael E. DeBakey VA Medical Center.
D.S. received support from VA CSR&D I01BX007080. T.R.K. received support from NIH/NIDA P50 DA018197. X.L. declares no conflicts of interest.
Please send correspondence to: Daryl Shorter, MD, Research Service Line, Michael E. DeBakey Veterans Affairs Medical Center, Assistant Professor, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 2002 Holcombe Blvd, Bldg 121, Office 121-137, Houston, TX 77030 (e-mail: firstname.lastname@example.org).