Nasal Opioid Agonist Treatment in Patients with Severe Opioid Dependence: A Case Series

被引:5
|
作者
Vogel, Marc [1 ,2 ]
Kock, Patrick [2 ]
Strasser, Johannes [2 ]
Kalbermatten, Christoph [3 ]
Binder, Hannes [4 ]
Dursteler, Kenneth M. [2 ]
Walter, Marc [2 ]
Falcato, Luis [5 ]
Krausz, Michael [6 ]
Kormann, Adrian [3 ]
机构
[1] Psychiat Serv Thurgovia, Div Subst Use Disorders, Psychiat Clin, Munsterlingen, Switzerland
[2] Univ Basel, Psychiat Clin, Basel, Switzerland
[3] ZOPA, Outpatient Addict Treatment, Zug, Switzerland
[4] Psychiat Baselland, Liestal, Switzerland
[5] Arud Ctr Addict Med, Zurich, Switzerland
[6] Univ British Columbia, Inst Mental Hlth, Dept Psychiat, Vancouver, BC, Canada
关键词
Heroin; Diacetylmorphine; Substitution; Route of administration; Harm reduction; INTRANASAL DIAMORPHINE SPRAY; INJECTING-RELATED INJURY; DRUG-USE; HEROIN; PHARMACOKINETICS; PHARMACODYNAMICS; DISEASE; PEOPLE; BURDEN; ROUTE;
D O I
10.1159/000516431
中图分类号
R194 [卫生标准、卫生检查、医药管理];
学科分类号
摘要
Introduction: Opioid agonist treatment (OAT) is the first-line treatment for opioid dependence. Currently available OAT options comprise oral (methadone and morphine) and sublingual (buprenorphine) routes of administration. In Switzerland and some other countries, severely opioid-dependent individuals with insufficient response to oral or sublingual OAT are offered heroin-assisted treatment (HAT), which involves the provision of injected or oral medical heroin (diacetylmorphine [DAM]). However, many patients on treatment with injectable DAM (i-HAT) suffer from injection-related problems such as deteriorated vein status, ulcerations, endocarditis, and abscesses. Other patients who do not respond to oral OAT do not inject but snort opioids, and are not eligible for i-HAT. For this population, there is no other short-acting OAT with rapid onset of action available unless they switch to injecting, which is associated with higher risks. Nasal DAM (n-HAT) could be an alternative treatment option suitable for both populations of patients. Methods: We present a case series of 3 patients on i-HAT who successfully switched to n-HAT. Results/Conclusions: This is the first description of the clinical use of the nasal route of administration for HAT. n-HAT may constitute an important risk-reduced rapid-onset alternative to i-HAT. In particular, it may be suited for patients with injection-related complications, or noninjecting opioid-dependent patients failing to respond to oral OAT.
引用
收藏
页码:80 / 85
页数:6
相关论文
共 50 条
  • [21] The treatment of opioid dependence
    Maslansky, Robert
    JOURNAL OF ADDICTIVE DISEASES, 2006, 25 (04) : 146 - 147
  • [22] Prevalence of Opioid Dependence and Opioid Agonist Treatment in the Berlin Custodial Setting: A Cross-Sectional Study
    von Bernuth, Kira
    Seidel, Peter
    Krebs, Julia
    Lehmann, Marc
    Neumann, Britta
    Konrad, Norbert
    Opitz-Welke, Annette
    FRONTIERS IN PSYCHIATRY, 2020, 11
  • [23] The treatment of opioid dependence
    Galanter, Marc
    AMERICAN JOURNAL OF PSYCHIATRY, 2006, 163 (09): : 1650 - 1650
  • [24] The treatment of opioid dependence
    Kelleher, Michael J. A. K.
    BRITISH JOURNAL OF PSYCHIATRY, 2006, 189 : 474 - 474
  • [25] The treatment of opioid dependence
    Albanese, Mark J.
    AMERICAN JOURNAL ON ADDICTIONS, 2007, 16 (03): : 251 - 251
  • [26] The treatment of opioid dependence
    Batey, Robert
    DRUG AND ALCOHOL REVIEW, 2006, 25 (06) : 651 - 652
  • [27] What is the benefit of inconsistent opioid agonist treatment in patients with prescription opioid use disorder?
    Weiss, R.
    Griffin, M. L.
    EUROPEAN PSYCHIATRY, 2023, 66 : S569 - S570
  • [28] Supervised injectable opioid agonist therapy in a supported housing setting for the treatment of severe opioid use disorder
    Brar, Rupinder
    Sutherland, Christy
    Nolan, Seonaid
    BMJ CASE REPORTS, 2019, 12 (07)
  • [29] Haloperidol for the treatment of opioid addiction in advanced cancer patients: a case series
    Parisi, Alessandro
    Pensieri, Maria Vittoria
    Cortellini, Alessio
    D'Orazio, Carla
    Ficorella, Corrado
    Verna, Lucilla
    Porzio, Giampiero
    JOURNAL OF ADDICTIVE DISEASES, 2020, 38 (02) : 229 - 234
  • [30] Opioid Substitution Treatment Using Buprenorphine for Management of Dependence on Natural Opioids: Case Series
    Kathiresan, Preethy
    Ambekar, Atul
    Sarkar, Siddharth
    INDIAN JOURNAL OF PSYCHOLOGICAL MEDICINE, 2019, 41 (06) : 586 - 588