Buprenorphine Is Underused

Background: Buprenorphine is a high affinity partial agonist at the opioid mu -opioid receptor, resulting in analgesia in the opiate naïve, blocking the effect of other opioids, and a ceiling effect where more drug does not produce more effect. It is an antagonist at opioid kappa- and delta-opioid receptors. Buprenorphine is safer than traditional opioids with less respiratory depression and overdose mortality. It can be used both for pain, due to its analgesic effect, and for medically assisted opioid dependency treatment due to its mu binding power. The Drug Enforcement Administration (DEA) has recently loosened restrictions on its use, so physicians can use it for both indications. Why did the DEA do that? Objective: To examine buprenorphine prescribing patterns in the United States. Design: Retrospective data review. Methods: The National Ambulatory Medical Survey, a retrospective observational database, with 248,164 visits, was reviewed for use of opioids and buprenorphine more...