The Handbook of Office-Based Buprenorphine Treatment of Opioid Dependence
will serve as a reliable guide for the addition of buprenorphine treatment into existing clinical practices, both for psychiatrists and other clinicians. Adopting a new treatment modality can be challenging, yet the need to expand treatment services to include buprenorphine is urgent—and this book meets both challenges. The potential to improve the lives of patients with the disease of opioid addiction is great, and this book offers concrete and practical advice for managing patients in an office-based setting. This handbook
- Highlights the importance of counseling as an essential component of quality buprenorphine treatment
- Provides the dimensions of assessment and available treatment options to ensure that patients receive the appropriate intensity of care
- Urges clinicians to locate therapists trained in cognitive-behavior therapy, motivational enhancement therapy, and 12-step facilitation
- Stresses the importance of care coordination with treatment counselors in order to deliver maximally effective buprenorphine treatment
Distinguished practicing psychiatrists, internists, and other clinical experts and researchers contribute their expertise with buprenorphine to this volume. It covers the subject matter thoroughly—from the history of opioid abuse and assessment criteria for potential patients to clinical management and psychiatric comorbidity. Chapters provide succinct conclusions and clinical pearls summarizing content regarding, among other topics,
- General opioid pharmacology and the efficacy and safety of buprenorphine treatment programs
- Detailed information about the clinical use of buprenorphine
- Clinical management strategies for successful integration of the medication into private practices
- Medical management, logistical considerations, and opioid use by adolescents
This handbook provides the tools and guidelines necessary to help providers cultivate a therapeutic environment for treating opioid addiction that minimizes problem behaviors and optimizes treatment outcomes. The requirements for setting up a successful office-based treatment program are provided in detail. A screening questionnaire for patients and sample informed consent forms are provided. Because there is flexibility in how the necessary elements can be incorporated into existing programs, providers will learn through this handbook how to tailor their opioid addiction treatment plan to the needs of their particular practice and patients. Case vignettes, charts, and tables make the subject matter easily accessible for readers ranging from students to well-established practitioners.
Clinicians will find this handbook an invaluable resource for successfully treating an increasing number of patients who struggle with the disease of opioid addiction.
Forward. Introduction. Opiate dependence in America: history and overview. Experience with buprenorphine in the United States 2002 to 2008. General opioid pharmacology. Efficacy and safety of buprenorphine. Patient assessment. Clinical use of buprenorphine. Clinical management I: buprenorphine treatment in office-based settings. Clinical management II: psychosocial and supportive treatment. Psychiatric comorbidity. Medical management. Management of acute and chronic pain. Opioid use by adolescents. Logistics of office-based buprenorphine treatment. Comments on the case vignettes. Appendix 1: useful web sites and recommended readings. Appendix 2: study questions and answer guide. Index.
"This handbook mirrors the buprenorphine course clinicians are required to take to be able to prescribe buprenorphine in an office-based setting as substitution therapy for opiate dependent individuals. It is an excellent addition to the course, going into a number of areas in greater detail than the face-to-face or online course is able to. The book contains most of the need-to-know information for anyone who wishes to become more knowledgeable or comfortable in this area."—Michael Easton, M.D., DOODY'S PUBLISHERS' CLUB
"The writing is thoughtful, concise, and practical, and case vignettes that highlight common patient presentations and potential pitfalls are provided. The chapters can be easily understood when read out of order. Clinical pearls that refer back to material in the chapter are provided at the end of each chapter
This volume is recommended for resident and non-resident physicians, nurses, therapists, and any healthcare provider or trainee wanting to learn more about and/or provide office-based treatment of opioid dependence with buprenorphine pharmacotherapy."—Michelle Lofwall, M.D., Journal of Psychiatric Practice March 2012
John A. Renner Jr., M.D., is Associate Professor of Psychiatry at Boston University School of Medicine and Director of the Addiction Psychiatry Residency Training Program at Boston University Medical Center and the VA Boston Healthcare System in Boston, Massachusetts.
Petros Levounis, M.D., M.A., is Director of The Addiction Institute of New York; Chief of the Division of Addiction Psychiatry at The St. Luke’s and Roosevelt Hospitals; and Associate Clinical Professor of Psychiatry at Columbia University College of Physicians and Surgeons in New York, New York.
Gregory Acampora, M.D.
Daniel P. Alford, M.D., M.P.H., F.A.C.P.
Jeffrey D. Baxter, M.D.
Patricia A. Cioe, M.S., R.N.P.
David A. Fiellin, M.D.
Peter D. Friedmann, M.D., M.P.H.
Petros Levounis, M.D., M.A.
Sharon Levy, M.D., M.P.H.
Elinore F. McCance-Katz, M.D., Ph.D.
John T. Pichot, M.D.
John A. Renner Jr., M.D.
Ricardo Restrepo, M.D., M.P.H.
Ximena Sanchez-Samper, M.D.
Eric C. Strain, M.D.
Lynn E. Sullivan, M.D.
Joji Suzuki, M.D.
Jeanette M. Tetrault, M.D.