Buprenorphine maintenance and mu -opioid receptor availability in the treatment of opioid use disorder: Implications for clinical use and policy

Highlights • We review data on BUP-induced changes in mu -opioid receptor ( μ OR) availability, pharmacokinetics and clinical efficacy. • Opioid withdrawal suppression appears to require ≤50% μ OR availability, associated with BUP plasma concentrations ≥1 ng/mL. • Blocking opioid reinforcement requi...

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Bibliographic Details
Published in:Drug and alcohol dependence 2014-11, Vol.144, p.1-11
Main Authors: Greenwald, Mark K, Comer, Sandra D, Fiellin, David A
Format: Article
Language:English
Subjects:
Administration, Sublingual
Analgesics, Opioid - administration & dosage
Analgesics, Opioid - metabolism
Buprenorphine
Buprenorphine - administration & dosage
Buprenorphine - metabolism
Health Policy - trends
Humans
Naloxone - administration & dosage
Naloxone - metabolism
Opiate Substitution Treatment - methods
Opioid dependence
Opioid receptors
Opioid-Related Disorders - drug therapy
Opioid-Related Disorders - metabolism
Policy
Positron emission tomography
Protein Binding - drug effects
Protein Binding - physiology
Psychiatry
Receptors, Opioid, mu - antagonists & inhibitors
Receptors, Opioid, mu - metabolism
Treatment
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Summary:Highlights • We review data on BUP-induced changes in mu -opioid receptor ( μ OR) availability, pharmacokinetics and clinical efficacy. • Opioid withdrawal suppression appears to require ≤50% μ OR availability, associated with BUP plasma concentrations ≥1 ng/mL. • Blocking opioid reinforcement requires
ISSN:0376-8716
1879-0046
DOI:10.1016/j.drugalcdep.2014.07.035