The Next Stage of Buprenorphine Care for Opioid Use Disorder
Authors: Mark H. Duncan, Anna D. Ratzliff, Diane M. Powers, Caleb J. Banta-Green, Andrew J. Saxon
Journal: Annals of Internal Medicine (2019)

Letters4 June 2019The Next Stage of Buprenorphine Care for Opioid Use DisorderMark H. Duncan, MD, Anna D. Ratzliff, MD, PhD, Diane M. Powers, MBA, MA, Caleb J. Banta-Green, PhD, and Andrew J. Saxon, MDMark H. Duncan, MDUniversity of Washington, Seattle, Washington (M.H.D.)Search for more papers by this author, Anna D. Ratzliff, MD, PhDUniversity of Washington, Advancing Integrated Mental Health Solutions Center, Seattle, Washington (A.D.R., D.M.P.)Search for more papers by this author, Diane M. Powers, MBA, MAUniversity of Washington, Advancing Integrated Mental Health Solutions Center, Seattle, Washington (A.D.R., D.M.P.)Search for more papers by this author, Caleb J. Banta-Green, PhDUniversity of Washington, Alcohol and Drug Abuse Institute, Seattle, Washington (C.J.B.)Search for more papers by this author, and Andrew J. Saxon, MDVeterans Affairs Puget Sound Health Care System and University of Washington, Seattle, Washington (A.J.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0144 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Martin and colleagues' much-needed article (1) documents the disconnect between common but outdated clinical practices and emerging evidence for lower-barrier care, as providers, payers, and policymakers struggle to catch up to the opioid epidemic (2–5). Washington State is implementing lower-barrier buprenorphine care in primary care offices, emergency departments, inpatient settings, prisons, and community-based syringe exchange facilities. The University of Washington supports these efforts, with staff serving as providers, clinical consultants, trainers, practice coaches, community educators, and researchers. Our experience with lower-barrier approaches points to challenges to consider when planning implementation of Martin and colleagues' recommendations.First, more ...References1. Martin SA, Chiodo LM, Bosse JD, Wilson A. The next stage of buprenorphine care for opioid use disorder. Ann Intern Med. 2018;169:628-35. [PMID: 30357262]. doi:10.7326/M18-1652 LinkGoogle Scholar2. Frost MC, Williams EC, Kingston S, Banta-Green CJ. Interest in getting help to reduce or stop substance use among syringe exchange clients who use opioids. J Addict Med. 2018;12:428-34. [PMID: 29889118] doi:10.1097/ADM.0000000000000426 CrossrefMedlineGoogle Scholar3. Hawk KF, Vaca FE, D'Onofrio G. Reducing fatal opioid overdose: prevention, treatment and harm reduction strategies. Yale J Biol Med. 2015;88:235-45. [PMID: 26339206] MedlineGoogle Scholar4. Kiluk BD, Fitzmaurice GM, Strain EC, Weiss RD. What defines a clinically meaningful outcome in the treatment of substance use disorders: reductions in direct consequences of drug use or improvement in overall functioning? Addiction. 2019;114:9-15. [PMID: 29900624] doi:10.1111/add.14289 CrossrefMedlineGoogle Scholar5. Stein MD, Herman DS, Moitra E, Hecht J, Lopez R, Anderson BJ, et al. A preliminary randomized controlled trial of a distress tolerance treatment for opioid dependent persons initiating buprenorphine. Drug Alcohol Depend. 2015;147:243-50. [PMID: 25510307] doi:10.1016/j.drugalcdep.2014.11.007 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Washington, Seattle, Washington (M.H.D.)University of Washington, Advancing Integrated Mental Health Solutions Center, Seattle, Washington (A.D.R., D.M.P.)University of Washington, Alcohol and Drug Abuse Institute, Seattle, Washington (C.J.B.)Veterans Affairs Puget Sound Health Care System and University of Washington, Seattle, Washington (A.J.S.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0144. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Next Stage of Buprenorphine Care for Opioid Use Disorder Stephen A. Martin , Lisa M. Chiodo , Jordon D. Bosse , and Amanda Wilson The Next Stage of Buprenorphine Care for Opioid Use Disorder Stephen A. Martin , Lisa M. Chiodo , Jordon D. Bosse , and Amanda Wilson The Next Stage of Buprenorphine Care for Opioid Use Disorder Robert Sherrick The Next Stage of Buprenorphine Care for Opioid Use Disorder Barbara Scolnick The Next Stage of Buprenorphine Care for Opioid Use Disorder Herbert Malinoff Metrics 4 June 2019Volume 170, Issue 11Page: 820-821KeywordsDisclosureDrugsInpatientsOpioidsPatientsPopulation statisticsQuality of lifeUrine ePublished: 4 June 2019 Issue Published: 4 June 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...