TY - JOUR KW - buprenorphine KW - dosing KW - opioid dependence KW - special groups AU - I. Maremmani AU - B. Rolland AU - L. Somaini AU - C. Roncero AU - J. Reimer AU - N. Wright AU - R. Littlewood AU - P. Krajci AU - H. Alho AU - O. D'Agnone AU - N. Simon A1 - AB - Introduction Treatment of opioid dependence with buprenorphine improves outcomes. Typical dosing ranges for all patients from clinical evidence and as defined in the product information are wide. For specific groups with complex clinical scenarios, there is no clear consensus on dosing choices to achieve best possible outcomes. Areas covered The doses of buprenorphine used in 6 European countries was reviewed. A review of published evidence supported rapid induction with buprenorphine and the benefits of higher doses but did not identify clearly useful guidance on dosing choices for groups with complex clinical scenarios. An expert group of physicians with experience in addiction care participated in a discussion meeting to share clinical practice experience and develop a consensus on dosing choices. Expert opinion There was general agreement that treatment outcomes can be improved by optimising buprenorphine doses in specific subgroups. Specific groups in whom buprenorphine doses may be too low and who could have better outcomes with optimised dosing were identified on the basis of clinical practice experience. These groups include people with severe addiction, high tolerance to opioids, and psychiatric comorbidities. In these groups it is recommended to review dosing choices to ensure buprenorphine dosing is sufficient. BT - Expert opinion on pharmacotherapy C5 - Opioids & Substance Use DO - 10.1080/14656566.2016.1209486 JF - Expert opinion on pharmacotherapy N2 - Introduction Treatment of opioid dependence with buprenorphine improves outcomes. Typical dosing ranges for all patients from clinical evidence and as defined in the product information are wide. For specific groups with complex clinical scenarios, there is no clear consensus on dosing choices to achieve best possible outcomes. Areas covered The doses of buprenorphine used in 6 European countries was reviewed. A review of published evidence supported rapid induction with buprenorphine and the benefits of higher doses but did not identify clearly useful guidance on dosing choices for groups with complex clinical scenarios. An expert group of physicians with experience in addiction care participated in a discussion meeting to share clinical practice experience and develop a consensus on dosing choices. Expert opinion There was general agreement that treatment outcomes can be improved by optimising buprenorphine doses in specific subgroups. Specific groups in whom buprenorphine doses may be too low and who could have better outcomes with optimised dosing were identified on the basis of clinical practice experience. These groups include people with severe addiction, high tolerance to opioids, and psychiatric comorbidities. In these groups it is recommended to review dosing choices to ensure buprenorphine dosing is sufficient. PY - 2016 SN - 1744-7666; 1465-6566 T1 - Buprenorphine dosing choices in specific populations: review of expert opinion T2 - Expert opinion on pharmacotherapy TI - Buprenorphine dosing choices in specific populations: review of expert opinion U1 - Opioids & Substance Use U2 - 27376622 U3 - 10.1080/14656566.2016.1209486 VO - 1744-7666; 1465-6566 Y1 - 2016 ER -