title: The unique role of transdermal buprenorphine in the global chronic pain epidemic.
abstract: Pain is a global epidemic, exacerbated by barriers to access of opioid analgesics. Regulations about opioids attempt to protect public health from the risks of harmful use of opioids, diversion, and dependence. Transdermal buprenorphine is an effective opioid analgesic agent with unique properties that may make it particularly well suited for more widespread use. It is a versatile analgesic product with demonstrated safety and effectiveness in cancer and noncancer pain populations. Its pharmacological properties make it a first-line opioid analgesic for geriatric patients and patients with renal dysfunction; no dosing adjustments need to be made. The 7-day transdermal delivery system is convenient for patients and promotes compliance. A low dose of buprenorphine can provide effective and well-tolerated pain relief. Although buprenorphine has been associated with certain opioid-related adverse effects, such as dizziness and nausea, it is associated with a lower rate of constipation than many other opioid analgesics. The potential for nonmedical use of buprenorphine is relatively low compared with other opioid agents. Buprenorphine has a relatively low likeability for nonmedical use and the transdermal matrix patch renders the substance particularly difficult to extract for illicit purposes.
authors.affiliation: The Johns Hopkins University School of Medicine, Department of Medicine, Baltimore, MD, United States; Temple University School of Medicine, Department of Pharmacology, Philadelphia, PA, United States.
authors.forename: Joseph V
authors.initials: JV
authors.lastname: Pergolizzi
authors.affiliation: Willem Scholten Consultancy, Medicines and Controlled Substances, Lopik, The Netherlands. Electronic address: wk.scholten@xs4all.nl.
authors.forename: Willem
authors.initials: W
authors.lastname: Scholten
authors.affiliation: Mundipharma Research, Ltd., Department of Clinical Pharmacology, Cambridge, United Kingdom.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Smith
authors.affiliation: Mundipharma Research, Ltd., Department of Drug Safety and Pharmacovigilance, Cambridge, United Kingdom.
authors.forename: James
authors.initials: J
authors.lastname: Leighton-Scott
authors.affiliation: Mundipharma Research, Ltd., Department of Drug Safety and Pharmacovigilance, Cambridge, United Kingdom.
authors.forename: Jenna C
authors.initials: JC
authors.lastname: Willis
authors.affiliation: Pinney Associates, Research, Health Policy and Abuse Liability, Bethesda, MD, United States; The Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, MD, United States.
authors.forename: Jack E
authors.initials: JE
authors.lastname: Henningfield
mesh_terms: D000279:Administration, Cutaneous; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D002047:Buprenorphine / Q000008:administration & dosage* / Q000009:adverse effects; D059350:Chronic Pain / Q000188:drug therapy*; D017281:Cost of Illness; D006801:Humans; D009293:Opioid-Related Disorders
chemical_list: D000701:Analgesics, Opioid; D002047:Buprenorphine
keywords: access to medicines; adverse effects; analgesia; buprenorphine; drug abuse; transdermal patch