title: Conversion from high-dose full-opioid agonists to sublingual buprenorphine reduces pain scores and improves quality of life for chronic pain patients.
abstract: OBJECTIVE
  This study aims to determine the effectiveness of converting patients from high doses of full-opioid agonists to sublingual (SL) buprenorphine.
  
  
  METHODS
  An observational report of outcomes assessment.
  
  
  METHODS
  An interventional pain management practice setting in the United States.
  
  
  METHODS
  Thirty-five chronic pain patients (age 24-66) were previously treated with high-dose opioid-agonist drugs and converted to SL buprenorphine. Patients' daily morphine equivalents ranged from 200 mg to 1,370 mg preconversion, with a mean daily dose of 550 mg.
  
  
  METHODS
  A retrospective chart analysis examined numerical pain levels and quality of life scores before and 2 months after conversion to SL buprenorphine.
  
  
  RESULTS
  After continuation of SL buprenorphine therapy for 2 months, the mean pain score decreased from 7.2 to 3.5 (P < 0.001), with 34 of the 35 patients examined reporting a decrease in pain. This pain score decrease was robust with regard to initial pain score and preconversion morphine equivalent dosage. Quality of life scores improved from 6.1 to 7.1 (P = 0.005).
  
  
  CONCLUSIONS
  Average pain scores decreased from 7.2 to 3.5, and quality of life scores increased from 6.1 to 7.1 for 35 patients converted from high-dose full-opioid agonists to SL buprenorphine therapy for more than 60 days. Clinicians should consider buprenorphine SL conversion for all patients on high-dose opioids, particularly patients with severe pain (7-10) unrelieved by their current opioid regimen or patients for whom the clinician does not feel comfortable prescribing high-dose opioids.
authors.affiliation: Jefferson Medical College, Philadelphia, Pennsylvania, USA.
authors.forename: Danielle
authors.initials: D
authors.lastname: Daitch
authors.forename: Jonathan
authors.initials: J
authors.lastname: Daitch
authors.forename: Daniel
authors.initials: D
authors.lastname: Novinson
authors.forename: Michael
authors.initials: M
authors.lastname: Frey
authors.forename: Carol
authors.initials: C
authors.lastname: Mitnick
authors.forename: Joseph
authors.initials: J
authors.lastname: Pergolizzi
mesh_terms: D000286:Administration, Sublingual; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000627:therapeutic use; D002047:Buprenorphine / Q000008:administration & dosage*; D059350:Chronic Pain / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058850:Opiate Substitution Treatment / Q000379:methods*; D059408:Pain Management / Q000379:methods*; D011788:Quality of Life; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D002047:Buprenorphine
keywords: Analgesia; Buprenorphine; Opioid Conversion; Opioid Tolerance; Opioid-Induced Hyperalgesia; Sublingual Buprenorphine