Date of Award

5-2020

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Julie Solberg

Keywords

Opioid Use Disorder; Buprenorphine; Office-Based Therapy; Emergency Department Initiated; Adverse Opioid-Related Event

Abstract

The subsequent review evaluates opioid use disorder (OUD) as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria, including the use of buprenorphine in the process of induction, its efficacy for the management of OUD, and barriers to its initiation. The outcomes of the initiation of office-based buprenorphine treatment are compared to emergency department-initiated buprenorphine treatment for the management of OUD. This project is a review of current meta-analysis, systematic reviews, cross-sectional, longitudinal, and survey methodologies were analyzed. The medical research databases PubMed, Embase, Cochrane Review, CINAHL Complete, and PsychINFO, have been utilized in obtaining peer-reviewed literature resources. The sources eliminated include those published before 2007, lacked a formal research format, or did not provide valid statistical information. A total of 20 sources were selected for this literature review. The research revealed that buprenorphine is effective in treating OUD when appropriate induction and maintenance doses are implemented. However, there continue to be barriers in prescribing buprenorphine resulting in limited access to the medication. Office-based buprenorphine treatment of OUD shows decreased engagement in treatment within the first 30 days. Emergency department-initiated buprenorphine treatment reveals increased participation in treatment within the first 30 and 60 days, a decrease in opioid use, and a decrease in adverse opioid-related events. The treatment outcome engagement data reveals that at the 6- and 12-month time frames, retention in buprenorphine therapy is essentially the same when comparing both treatment modalities.

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