Methadone and buprenorphine are widely used to treat substance abuse. Both medications have a dual purpose, with one objective designed to treat substance use disorder (SUD) as well as being an effective analgesic. Greater utilization of both medications resurfaced with the increase in substance abuse during the COVID-19 pandemic. When compared to various opioids, such as morphine, fentanyl, and tramadol, buprenorphine provides fewer side effects. In addition, patients are less likely to have respiratory depression and euphoria from buprenorphine.3 The pharmacokinetics of buprenorphine are relatively stable in renal failure, and doses do not have to be altered in mild to moderate hepatic impairment.4 Furthermore, other opioids such as morphine, fentanyl and tramadol require adjustments for renal and hepatic impairment. Therefore, the need for other opioids may diminish in patients who have a known hx of SUD, since buprenorphine and methadone have the added benefit of treating opioid use disorder (OUD) and pain.
Poole T. The Multifunctional Use of Methadone and Buprenorphine in Patients with Known Substance. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2023; 5(1).
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