New directions in the treatment of opioid withdrawal.

Abstract

The treatment of opioid withdrawal is an important area of clinical concern when treating patients with chronic, non-cancer pain, patients with active opioid use disorder, and patients receiving medication for opioid use disorder. Current standards of care for medically supervised withdrawal include treatment with μ-opioid receptor agonists, (eg, methadone), partial agonists (eg, buprenorphine), and α2-adrenergic receptor agonists (eg, clonidine and lofexidine). Newer agents likewise exploit these pharmacological mechanisms, including tramadol (μ-opioid receptor agonism) and tizanidine (α2 agonism). Areas for future research include managing withdrawal in the context of stabilising patients with opioid use disorder to extended-release naltrexone, transitioning patients with opioid use disorder from methadone to buprenorphine, and tapering opioids in patients with chronic, non-cancer pain.

• Authors: A Benjamin Srivastava, John J Mariani, Frances R Levin
• Journal: Lancet (London, England) (Lancet) Vol. 395 Issue 10241 Pg. 1938-1948 (06 20 2020) ISSN: 1474-547X [Electronic] England
• PMID: 32563380 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Review)
• Copyright: Copyright © 2020 Elsevier Ltd. All rights reserved.

Chemical References

• Adrenergic alpha-2 Receptor Agonists
• Analgesics, Opioid
• Narcotic Antagonists

Topics

• Adrenergic alpha-2 Receptor Agonists (administration & dosage, adverse effects)
• Analgesics, Opioid (administration & dosage, adverse effects)
• Drug Administration Schedule
• Humans
• Narcotic Antagonists (administration & dosage, adverse effects)
• Opiate Substitution Treatment (methods)
• Opioid-Related Disorders (drug therapy)
• Substance Withdrawal Syndrome (drug therapy)