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Crushed Buprenorphine or Buprenorphine-Naloxone for Opioid Dependency: A Review of the Clinical Effectiveness and Guidelines

Published on: July 18, 2016
Project Number: RC0794-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness and safety of sublingual crushed buprenorphine for treating opioid dependency?
  2. What is the clinical effectiveness and safety of sublingual crushed buprenorphine-naloxone for treating opioid dependency?
  3. What are the evidence-based guidelines regarding the administration of crushed buprenorphine or crushed buprenorphine-naloxone for the treatment of opioid dependency?

Key Message

A single crossover RCT with 16 patients showed that there were no statistically significant differences with respect to opioid withdrawal or opioid craving between treatments with the whole buprenorphine tablet or the crushed tablet. The number of patients experiencing adverse events was higher in the crushed tablet group compared to the whole tablet group however there were no serious adverse events reported in either group. There was no information identified regarding the effectiveness of the crushed tablet in resolving misuse and diversion issues. No relevant studies comparing sublingual administration of crushed buprenorphine-naloxone with uncrushed buprenorphine or uncrushed buprenorphine-naloxone tablets or buprenorphine-naloxone film for the treatment of opioid dependency were identified. No evidence based guidelines on the use of crushed buprenorphine or crushed buprenorphine-naloxone were identified.

Tags

administration, buprenorphine, drug users, naloxone, opiate substitution treatment, opioid-related disorders, subutex, tablets, other miscellaneous topics, Sublingual, Suboxone