title: Patients that benefit from buprenorphine-naloxone on medically assisted treatment for opioid dependence in Malaysia.
abstract: BACKGROUND
  Opioid dependence is recorded as the most common drug of abuse in Malaysia. Currently, the preferred substitution therapy for most Government treatment centres is methadone used as substitution therapy for opioid dependence. There are, however patients who may benefit from being on the combined buprenorphine-naloxone formulation as substitution therapy instead. We discuss six cases of opioid dependence of varied backgrounds that were treated with buprenorphinenaloxone therapy and their outcomes.
  
  
  CONCLUSIONS
  All of the reported patients improved after the induction of buprenorphine- naloxone. Two of the cases highlighted the transfer of patients on methadone to buprenorphine-naloxone due to the adverse effect and interactions of methadone with other medications. During the transfer there were no major adverse reactions noted, and patients were safely able to continue with the maintenance therapy of buprenorphine- naloxone.
  
  
  CONCLUSIONS
  Buprenorphine-naloxone is a safe and effective drug substitution therapy for opioid dependence. It has fewer interactions with other medications, and has similar efficacy to methadone. Being a partial agonist, it has a less sedating effect making patients more functional.
authors.affiliation: International Medical University, Department of Psychiatry, Clinical School, Jalan Rasah, 70300, Seremban, Negeri Sembailan, Malaysia. drphilgeorge@gmail.com.
authors.forename: P
authors.initials: P
authors.lastname: George
authors.affiliation: Hospital Kuala Pilah, Department of Psychiatry, Negeri Sembailan, Malaysia.
authors.forename: P
authors.initials: P
authors.lastname: Ramasamy
authors.affiliation: Monash University, Department of Psychiatry, Johor Bahru, Johor, Malaysia.
authors.forename: S
authors.initials: S
authors.lastname: Thurairajasingam
authors.affiliation: PERTIWI Health Services, Kuala Lumpur, Malaysia.
authors.forename: Z
authors.initials: Z
authors.lastname: Shah