TY - JOUR
KW - Analgesics, Opioid/therapeutic use
KW - Buprenorphine/therapeutic use
KW - Humans
KW - Methadone/therapeutic use
KW - Narcotic Antagonists/therapeutic use
KW - Opiate Substitution Treatment
KW - Opioid-Related Disorders/drug therapy
AU - J. E. Zweben
AU - J. L. Sorensen
AU - M. Shingle
AU - C. K. Blazes
A1 - 
AB - This paper offers a review and recommendations for clinicians working with patients interested in discontinuing opioid agonist treatment. As buprenorphine/naloxone has gained widespread acceptance for opioid addiction, many treatment providers and patients have a range of hopes and expectations about its optimal use. A surprising number assume buprenorphine/naloxone is primarily useful as a medication to transition off illicit opioid use, and success is partially defined by discontinuing the medication. Despite accumulating evidence that a majority of patients will need to remain on medication to preserve their gains, clinicians often have to address a patient's fervent desire to taper. Using the concept of "recovery capital," our review addresses (1) the appropriate duration of opioid agonist treatment, (2) risks associated with discontinuing, (3) a checklist that guides the patient through self-assessment of the wisdom of discontinuing opioid agonist treatment, and (4) shared decision making about how to proceed.
AD - San Francisco VA Medical Center, University of California, San Francisco, CA (JEZ), Department of Psychiatry and Behavioral Sciences, Zuckerberg San Francisco General Hospital, University of California, San Francisco, CA (JLS), Department of Psychiatry and Behavioral Sciences, Zuckerberg San Francisco General Hospital, University of California, San Francisco, CA (MS), Oregon Health and Science University, Portland VA Hospital, Portland, OR (CKB).
BT - Journal of addiction medicine
C5 - Education & Workforce; Opioids & Substance Use
CP - 6
CY - United States
DO - 10.1097/ADM.0000000000000789
IS - 6
JF - Journal of addiction medicine
LA - eng
M1 - Journal Article
N2 - This paper offers a review and recommendations for clinicians working with patients interested in discontinuing opioid agonist treatment. As buprenorphine/naloxone has gained widespread acceptance for opioid addiction, many treatment providers and patients have a range of hopes and expectations about its optimal use. A surprising number assume buprenorphine/naloxone is primarily useful as a medication to transition off illicit opioid use, and success is partially defined by discontinuing the medication. Despite accumulating evidence that a majority of patients will need to remain on medication to preserve their gains, clinicians often have to address a patient's fervent desire to taper. Using the concept of "recovery capital," our review addresses (1) the appropriate duration of opioid agonist treatment, (2) risks associated with discontinuing, (3) a checklist that guides the patient through self-assessment of the wisdom of discontinuing opioid agonist treatment, and (4) shared decision making about how to proceed.
PP - United States
PY - 2021
SN - 1935-3227; 1932-0620
SP - 454
EP - 460
EP - 
T1 - Discontinuing Methadone and Buprenorphine: A Review and Clinical Challenges
T2 - Journal of addiction medicine
TI - Discontinuing Methadone and Buprenorphine: A Review and Clinical Challenges
U1 - Education & Workforce; Opioids & Substance Use
U2 - 33323695
U3 - 10.1097/ADM.0000000000000789
VL - 15
VO - 1935-3227; 1932-0620
Y1 - 2021
Y2 - Nov-Dec 01
ER -