Review Article
Rashel Nimroozi, David J Ma
Abstract
Abuse of opioid based prescription drugs is an ongoing global health concern that affects millions of individuals worldwide. The economic burden from this abuse has led to the development of treatment programs and the use of methadone maintenance in clinics. Yet, methadone itself has abuse liability and is misused in ways such as crushed for nasal insufflation or dissolved for subsequent intravenous injection. Later, a newer synthetic opioid working as a partial agonist at the mu-opioid receptor, buprenorphine (Subutex®), became available for outpatient use.This new opioid produces restricted euphoria, decreases withdrawal symptoms, and can prevent displacement of buprenorphine should the user decide to take illicit opioids. Due to high risk of abuse, the product was discontinued and now only available as a combination (Suboxone®) with the opioid antagonist naloxone.Users who abuse the combination product by parenteral routes will have euphoric effects cancelled by the presence of naloxone. Such novel dosage forms having additional physical and/or pharmacological barriers can provide a safe and effective option for medication-assisted treatment of opioid addiction with increased access to care.