TY - JOUR
KW - Acetaminophen/administration & dosage/adverse effects
KW - Analgesics, Opioid/administration & dosage/adverse effects
KW - Buprenorphine/therapeutic use
KW - Chronic Pain/diagnosis/drug therapy
KW - Codeine/administration & dosage/adverse effects
KW - Counseling
KW - Fatigue Syndrome, Chronic/diagnosis/drug therapy
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Naloxone/therapeutic use
KW - Narcotic Antagonists/therapeutic use
KW - Opioid-Related Disorders/diagnosis/drug therapy
KW - Primary Health Care/methods
KW - Risk Assessment
KW - Severity of Illness Index
KW - Treatment Outcome
KW - Young Adult
AU - B. Hard
A1 - 
AB - Opioid painkiller dependence is a growing problem and best-practice management is not well defined. We report a case of a young woman exhibiting dependence on codeine, originally prescribed for myalgic encephalopathy, after escalating use over a 10-year period. In 2012, a consultation with a new general practitioner, who had extensive experience of patients with substance abuse, revealed the underlying dependence. After building trust for 6 months, she was able to admit to medication abuse, and was referred to the community drug and alcohol team. On presentation to the team, the patient had no pain issues and the dihydrocodeine use--600 tablets/week--solely reflected her dependence. The patient successfully underwent rapid induction with buprenorphine/naloxone as opioid substitution treatment over 2 days. She is currently stable, engaged with recovery support services and psychosocial counselling, and has just returned to work. She is maintained on a therapeutic dose of buprenorphine 10 mg/naloxone 2.5 mg.
BT - BMJ case reports
C5 - Opioids & Substance Use
CY - England
DO - 10.1136/bcr-2014-207308
JF - BMJ case reports
N2 - Opioid painkiller dependence is a growing problem and best-practice management is not well defined. We report a case of a young woman exhibiting dependence on codeine, originally prescribed for myalgic encephalopathy, after escalating use over a 10-year period. In 2012, a consultation with a new general practitioner, who had extensive experience of patients with substance abuse, revealed the underlying dependence. After building trust for 6 months, she was able to admit to medication abuse, and was referred to the community drug and alcohol team. On presentation to the team, the patient had no pain issues and the dihydrocodeine use--600 tablets/week--solely reflected her dependence. The patient successfully underwent rapid induction with buprenorphine/naloxone as opioid substitution treatment over 2 days. She is currently stable, engaged with recovery support services and psychosocial counselling, and has just returned to work. She is maintained on a therapeutic dose of buprenorphine 10 mg/naloxone 2.5 mg.
PB - BMJ Publishing Group Ltd
PP - England
PY - 2014
SN - 1757-790X; 1757-790X
T1 - Management of opioid painkiller dependence in primary care: Ongoing recovery with buprenorphine/naloxone
T2 - BMJ case reports
TI - Management of opioid painkiller dependence in primary care: Ongoing recovery with buprenorphine/naloxone
U1 - Opioids & Substance Use
U2 - 25432908
U3 - 10.1136/bcr-2014-207308
VL - 2014
VO - 1757-790X; 1757-790X
Y1 - 2014
ER -