Reconsidering the Usefulness of Adding Naloxone to Buprenorphine

Study Author(s):

Christopher K. Blazes and Jonathan D. Morrow

Journal Name:

Frontiers in Psychiatry

Publication Date:

September 2020

PMID:

33061915

We are in the middle of an opioid epidemic with tens of thousands of lives lost every year. As we combat this problem, it is critically important that we continually scrutinize our research efforts and care strategies in the spirit of the scientific method. Especially in light of a death toll that lowered overall US life expectancy for the first time since the flu pandemic in World War I, (1) we must maintain our readiness to reconsider well-established theories and practices in order to improve our efforts to contain this crisis. These efforts will require precision and accuracy in our translation of the literature base. One of the most effective interventions for opioid use disorder has been buprenorphine maintenance therapy, largely using a combination of buprenorphine and naloxone. However, evidence accumulated particularly over the last decade indicates that adding naloxone to buprenorphine may not be as effective a deterrent to misuse by parenteral (i.e., outside the gastrointestinal tract) administration as once thought, and for many patients, naloxone may in fact make the combination product less safe than buprenorphine monotherapy.