American Society of Addiction Medicine
American Society of Addiction Medicine
Lead: The Howard Street Method: A Community Pharmacy-Led Low Dose Overlap Buprenorphine Initiation Protocol for Individuals Using Fentanyl
Lead: The Howard Street Method: A Community Pharmacy-Led Low Dose Overlap Buprenorphine Initiation Protocol for Individuals Using Fentanyl
Lead: The Howard Street Method: A Community Pharmacy-Led Low Dose Overlap Buprenorphine Initiation Protocol for Individuals Using Fentanyl
Tuesday 28th February 2023
Learn about The Howard Street Method's community pharmacy-led buprenorphine initiation for fentanyl users and other addiction medicine insights.
7 minutes
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American Society of Addiction Medicine
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Innovative Treatments & Recovery Paths
Navigating Alcohol Dependency
Family Recovery from Addiction
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Get the buttons here!The Howard Street Method: Revolutionizing Buprenorphine Initiation for Fentanyl Users
The Howard Street Method offers an innovative approach to buprenorphine initiation that could help more individuals with opioid use disorder access effective treatment.
Imagine a community pharmacy stepping up to tackle one of the biggest challenges in addiction medicine: initiating buprenorphine for individuals using fentanyl. This episode of 'This Week in Addiction Medicine' introduces The Howard Street Method, a low dose overlap buprenorphine initiation protocol that’s making waves. This innovative approach involves a blister pack with a 7-day titration schedule, starting from 0.5 mg and increasing to 4 mg daily.
Out of twenty-six patients, fourteen completed the protocol with 79% reporting no withdrawal symptoms and 21% experiencing only mild symptoms. Even more promising, at thirty days, 71% were still on buprenorphine, and at 180 days, 43% remained in care. This method could be a game-changer for high-risk populations needing effective treatment. But that’s not all this episode covers.
It also dives into the impact of stimulant use on starting medications for opioid use disorder, revealing that stimulants might reduce the likelihood of initiating these medications. Another study highlighted discusses the out-of-pocket costs for buprenorphine, showing significant cost differences depending on the insurer, with Medicaid being the least expensive and self-pay the most costly. The episode doesn’t shy away from the complex intersection of substance use and mental health either.
It examines how comorbid psychiatric and substance use disorders affect hospitalization rates among COVID-19 patients treated in U.S. emergency departments. Plus, it explores the role of financial capacity in delivering opioid use disorder treatment and the therapeutic potential of psychedelics from a European regulatory perspective. Lastly, the discussion extends to over-the-counter naloxone access and its challenges and opportunities, as well as the association between MDMA and social functioning.
This episode is packed with crucial insights and emerging trends in addiction medicine, offering hope and practical knowledge for anyone touched by these issues.