Name of the Procedure:

Common Name(s): Buprenorphine/Naloxone Therapy Technical Term: Buprenorphine/Naloxone, oral, greater than 3 mg, but less than or equal to 6 mg buprenorphine (HCPCS code J0573)

Summary:

Buprenorphine/Naloxone therapy involves the oral administration of a medication that combines buprenorphine and naloxone. This treatment is primarily used to help manage opioid dependence by reducing withdrawal symptoms and cravings.

Purpose:

This medication is prescribed to manage opioid dependence and addiction. The goal is to help patients reduce or stop their use of opioid drugs while minimizing withdrawal symptoms and cravings.

Indications:

• Opioid dependence or addiction.
• Patients who have undergone initial detoxification.
• Patients who require maintenance treatment to stabilize their condition.

Preparation:

• Patients need to be in a moderate state of opioid withdrawal before beginning treatment.
• Patients should avoid any use of opioids 12-24 hours prior to the first dose.
• Relevant medical history and current medications should be reviewed by the healthcare provider.

Procedure Description:

1. A healthcare provider assesses the patient's level of opioid withdrawal.
2. The appropriate dosage of Buprenorphine/Naloxone is administered.
3. The patient takes the medication orally, as tablets may need to dissolve under the tongue.
4. The provider monitors the patient for any immediate adverse reactions.

Tools and Equipment:

• Oral tablets or films containing Buprenorphine/Naloxone.
• Equipment for monitoring vital signs.

Anesthesia or Sedation:

• None required.

Duration:

• Initial assessment and administration: Approximately 1-2 hours.
• Monitoring may continue for additional hours depending on the patient's response.

Setting:

Typically performed in an outpatient clinic, doctor's office, or specialized treatment center.

Personnel:

• Physicians or addiction specialists.
• Nurses or medical assistants.

Risks and Complications:

• Common: Nausea, headache, constipation, insomnia, sweating.
• Rare: Respiratory depression, severe allergic reactions, liver dysfunction.
• Management: Symptomatic treatment for side effects, emergency services for severe reactions.

Benefits:

• Reduction in opioid cravings and withdrawal symptoms.
• Improved ability to engage in therapeutic activities and daily life.
• Benefits can be seen within hours of administration.

Recovery:

• Patients can often resume normal activities soon after taking the medication.
• Follow-up appointments are crucial for adjusting dosage and monitoring progress.
• Patients are advised to continue with counseling and support groups.

Alternatives:

• Methadone maintenance therapy.
• Naltrexone therapy.
• Pros and Cons: Methadone requires daily clinic visits but is also effective; Naltrexone requires a complete detox beforehand and carries a risk of precipitated withdrawal.

Patient Experience:

• During: Patients may experience initial relief from withdrawal symptoms within 30-60 minutes.
• After: Some patients may feel mild nausea or dizziness. These symptoms usually improve over time.
• Pain Management: Over-the-counter pain relievers may be used for mild discomfort; severe pain should be reported to a healthcare provider.