With a new foreword by Nora Volkow, Director of the National Institute on Drug Abuse, this second edition of Office-Based Buprenorphine Treatment of Opioid Use Disorder provides updated information on evidence-based treatment for opioid use disorder (OUD) -- an increasingly important topic as the epidemic of opioid misuse and overdose deaths grows in the United States. Bulleted clinical pearls at the end of each chapter, as well as specific clinical recommendations and detailed case discussions throughout, make it easier for readers to retain knowledge and integrate it into their clinical practice. The guide also features sample documentation and scales, including a treatment contract and a patient consent, that can be used to model documents in practice. This new edition of Office-Based Buprenorphine Treatment has been updated to reflect DSM-5 language, and two additional chapters have been included: one that addresses other pharmacotherapies useful in treating OUD, including methadone and naltrexone, and another that discusses OUD treatment specifically with regard to women's health and pregnancy. Among the numerous other revisions included in the second edition are the following: • Information about new formulations of buprenorphine • A discussion of the Comprehensive Addiction and Recovery Act (CARA) • Changes to induction and maintenance target doses and recommendations for home inductions • Information on diversion control plans • Advice for working with Alcoholics Anonymous and Narcotics Anonymous • A discussion on integrating buprenorphine into residential and inpatient opioid treatment programs Written in a jargon-free style that does not require expertise in substance use disorder treatment, Office-Based Buprenorphine Treatment of Opioid Use Disorder is an accessible, indispensable reference for primary care physicians, psychiatrists, nurse practitioners, residents, medical students, and anyone with an interest in learning about and prescribing buprenorphine. Reviews: Handbook of Office Based Buprenorphine Treatment of Opioid Dependence, Second Edition is an invaluable guide to any provider licensed to prescribe this evidence-based medication assisted treatment for Opioid Dependence. Experts in the field provide detailed chapters on topics such as Data on Rates and Use of Overdose Deaths, Efficacy and Safety of Buprenorphine, Clinical Use in Dosing Involving Special Populations such as Adolescents, Pregnant Women, and Patients with Pain, as well as sections on Psychiatric and Medical Comorbidities. In addition to being an excellent guide for prescribers of Buprenorphine, this text serves as an excellent learning tool for medical students, residents, fellows in addiction medicine or addition psychiatry, and medical providers interested in treating this challenging, but potentially very rewarding population.—Lon R. Hays, M.D., MBA, Professor and Chairman, Department of Psychiatry, University of Kentucky The Handbook of Office Based Buprenorphine Treatment of Opiate Dependence, 2e is the long sought after missing link to effective and comprehensive Opiate treatment. This masterful manuscript provides the expert clinical guidance that both novice and experienced practitioners will find to be immediately useful. The comprehensiveness of this handbook is unmatched and invaluable for those seeking to provide state of the art competent Opiate dependence treatment.—Louis E. Baxter, Sr., M.D., DFASAM, President & CEO, Professional Assistance Program New Jersey, Inc., Past President ASAM, Director ABAM, Co-Director Addiction Medicine Fellowship Howard University Hospital This book is the most up-to-date resource on the principal office-based treatment for opioid-dependent patients. Because it draws on the leadership of the addiction field, and is comprehensive and clearly focused, both experienced physicians and those new to these patients can turn to it with great confidence.—Marc Galanter, M.D., Professor of Psychiatry, NYU School of Medicine, New York, New York The Handbook of Office-Based Buprenorphine Treatment of Opioid Dependence, Second Edition, provides a thorough tour of every aspect of using this medication to care for patients and, through its clear, well-organized structure, encourages the reader to pinpoint precisely and readily the specific guidance needed even in the midst of a clinical encounter. This book serves as a perfect companion to buprenorphine training courses because it codifies and amplifies all the knowledge gained in the course.—Andrew J. Saxon, M.D., Professor and Director, Addiction Psychiatry Residency Program, Department of Psychiatry & Behavioral Sciences, University of Washington, Director, Center of Excellence in Substance Abuse Treatment and Education (CESATE), VA Puget Sound Health Care System Treatment for addictive disease must break through long-existing stigma to be incorporated into the fabric of the medical treatment community. Education is the key to breaking through stigma. Renner, Levounis, and LaRose expertly educate by answering buprenorphine-related questions asked by both longstanding addiction practitioners and general practice clinicians. By adding historic perspective, the authors provide necessary context to help clinicians reduce morbidity and mortality in their patient population.—Stuart Gitlow, M.D., MPH, Past President, American Society of Addiction Medicine Contents: Contributors Dedication Foreword Obtaining the Buprenorphine Waiver Chapter 1. Opioid Use Disorder in America: History and Overview Chapter 2. General Opioid Pharmacology Chapter 3. Efficacy and Safety of Buprenorphine Chapter 4. Patient Assessment Chapter 5. Clinical Use of Buprenorphine Chapter 6. Buprenorphine Treatment in Office-Based Settings Chapter 7. Psychosocial and Supportive Treatment Chapter 8. Referral, Logistics, and Diversion Chapter 9. Methadone, Naltrexone, and Naloxone Chapter 10. Psychiatric Comorbidity Chapter 11. Medical Comorbidity Chapter 12. Acute and Chronic Pain Chapter 13. Opioid Use by Adolescents Chapter 14. Women’s Health and Pregnancy Chapter 15. Comments on the Case Vignettes Appendix 1: Useful Web Sites and Recommended Readings Appendix 2: Buprenorphine and Office-Based Treatment of Opioid Use Disorder Supplemental Materials Index Contributors: Gregory Acampora, M.D. Daniel P. Alford, M.D. Elie Aoun, M.D. Jonathan Avery, M.D. Jeffrey D. Baxter, M.D. Joseph H. Donroe, M.D. Beatrice A. Eld Gerard Iru I. Fernando, M.D. David A. Fiellin, M.D. Lynn E. Fiellin, M.D. Peter D. Friedmann, M.D. Saria El Haddad, M.D. Hendree Jones, Ph.D. Sharon Levy, M.D. Elinore F. McCance-Katz, M.D., Ph.D. Dong Chan Park, M.D. Tae Woo Park, M.D. John T. Pichot, M.D. Mark T. Pichot, D.O. Ricardo Restrepo, M.D. Claudia P. Rodriguez, M.D. Ximena Sanchez-Samper, M.D. Brad W. Stankiewicz, M.D. Eric C. Strain, M.D. Joji Suzuki, M.D. Jeanette M. Tetrault, M.D. Erin Zerbo, M.D. About the Editors: John A. Renner Jr., M.D., is Professor of Psychiatry at Boston University School of Medicine and Associate Chief of Psychiatry of the VA Boston Healthcare System in Boston, Massachusetts. Petros Levounis, M.D., M.A., is Professor and Chair of the Department of Psychiatry at Rutgers New Jersey Medical School and Chief of Service at University Hospital in Newark, New Jersey. Anna T. LaRose, M.D., is Instructor in Psychiatry at Boston University Medical School and Staff Psychiatrist at the VA Boston Healthcare System in Boston, Massachusetts.
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