title: Update on the clinical use of buprenorphine: in opioid-related disorders.
abstract: OBJECTIVE
  To review the current evidence on buprenorphine-naloxone for the treatment of opioid-related disorders, with a focus on primary care settings.
  
  
  METHODS
  MEDLINE and the Cochrane Database of Systematic Reviews were searched. Evidence is mainly level I.
  
  
  RESULTS
  Buprenorphine is a partial μ-opioid agonist and κ-opioid antagonist with a long half-life and less abuse potential than methadone. For detoxification, buprenorphine is at least equivalent to methadone and is superior to clonidine. For maintenance treatment, buprenorphine is clearly superior to placebo. Methadone has a slight advantage in terms of retention in treatment, but a stepped approach with initial use of buprenorphine-naloxone is as efficacious. Use of buprenorphine in the primary care setting is feasible, safe, and effective. Authorization to prescribe buprenorphine can be obtained after completing online training.
  
  
  CONCLUSIONS
  Buprenorphine is a safe and effective agent for detoxification from opioids. It can be used as a first-line agent in maintenance programs, owing to its lower abuse potential relative to other opioids. Its effectiveness in primary care settings makes it a useful therapeutic tool for family physicians.
authors.affiliation: Department of Psychiatry, McGill University, Montreal, Que, Canada. simon.ducharme@mail.mcgill.ca
authors.forename: Simon
authors.initials: S
authors.lastname: Ducharme
authors.forename: Ronald
authors.initials: R
authors.lastname: Fraser
authors.forename: Kathryn
authors.initials: K
authors.lastname: Gill
mesh_terms: D000701:Analgesics, Opioid / Q000494:pharmacology / Q000627:therapeutic use*; D002047:Buprenorphine / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008658:Inactivation, Metabolic; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D019966:Substance-Related Disorders / Q000188:drug therapy*
chemical_list: D000701:Analgesics, Opioid; D002047:Buprenorphine