title: Buprenorphine diversion and misuse in outpatient practice.
abstract: This case is an amalgamation of several real patients in office-based treatment for prescription opioid dependence synthesized into a single theoretical case. The case illustrates the various ways in which medication diversion and misuse may be encountered in clinical practice and therapeutic responses designed to maximize positive treatment outcomes. It is followed by discussions from several expert addiction medicine providers from 3 different countries, giving their perspectives on the salient aspects of this case. This case conference should be of particular interest to clinicians working with opioid-dependent patients in an outpatient setting.
authors.affiliation: From the Departments of Behavioral Science and Psychiatry (MRL), Center on Drug and Alcohol Research, University of Kentucky College of Medicine, Lexington; Department of Public Health (JM), City and County of San Francisco, San Francisco, CA; Office-Based Buprenorphine Induction Clinic and Centralized Opiate Placement Evaluation Clinics (MT), Division of Substance Abuse and Addiction Medicine, Department of Psychiatry, San Francisco General Hospital, San Francisco, CA; Université de Bordeaux (Segalen) and Laboratoire de psychiatrie/SANPSY (MF, MA), CNRS USR 3413, Bordeaux, France, and Département d'Addictologie (MF, MA), CH Charles Perrens and CHU de Bordeaux, Bordeaux, France; Drug & Alcohol Services (NL), South East Sydney Local Health District, Caringbah, New South Wales, Australia; NSW Ministry of Health (NL), Sydney, New South Wales, Australia; and University of Sydney (NL), Darlington New South Wales, Australia.
authors.forename: Michelle R
authors.initials: MR
authors.lastname: Lofwall
authors.forename: Judith
authors.initials: J
authors.lastname: Martin
authors.forename: Matt
authors.initials: M
authors.lastname: Tierney
authors.forename: Mélina
authors.initials: M
authors.lastname: Fatséas
authors.forename: Marc
authors.initials: M
authors.lastname: Auriacombe
authors.forename: Nicholas
authors.initials: N
authors.lastname: Lintzeris
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D002047:Buprenorphine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D064226:Prescription Drug Diversion; D063487:Prescription Drug Misuse
chemical_list: D009292:Narcotic Antagonists; D002047:Buprenorphine