Oral Health Risks of Transmucosal Buprenorphine: Commentary on Tuan et al. and Zheng et al.

IF 4.2 3区 医学 Q1 SUBSTANCE ABUSE
Anne C Black, William C Becker
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引用次数: 0

Abstract

Opioid use disorder affects millions of people nationally and in 2022 opioid overdose deaths exceeded 80,000. Buprenorphine, a partial mu-opioid receptor agonist, is a gold standard treatment for opioid use disorder, improving withdrawal symptoms and decreasing opioid-related mortality. However, a 2022 Food and Drug Administration warning about oral health problems related to transmucosal formulations has precipitated new research into this medication's potential risks. Two timely studies included in this issue of Journal of Addiction Medicine provide important new insight into potential causal effects and mechanisms of transmucosal buprenorphine's impact on oral disease. Using propensity score-weighted survival analysis, Tuan and colleagues demonstrated significantly greater risk for oral health problems in patients with opioid use disorder exposed to transmucosal buprenorphine compared to those not exposed. Taking a vastly different approach, Zheng and colleagues explored mechanisms of oral health risk by exposing rats to transmucosal or intravenous buprenorphine. Results described prolonged oral fluid buprenorphine exposure, a condition proposed to increase risk for tooth decay, was associated with greater accumulated buprenorphine in the salivary gland associated with sublingual buprenorphine administration. These novel studies advance our understanding of the plausibility of a causal relationship between transmucosal buprenorphine and oral health problems and suggest the importance of prescriber-patient discussions about risk mitigating oral hygiene practices and close monitoring of oral disease development. Additional research is needed into the relative oral health risks of full-opioid agonist versus transmucosal buprenorphine exposure and current barriers to long-acting injectable buprenorphine.

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来源期刊
Journal of Addiction Medicine
Journal of Addiction Medicine 医学-药物滥用
CiteScore
6.10
自引率
9.10%
发文量
260
审稿时长
>12 weeks
期刊介绍: The mission of Journal of Addiction Medicine, the official peer-reviewed journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical sub-specialty. Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics including: •addiction and substance use in pregnancy •adolescent addiction and at-risk use •the drug-exposed neonate •pharmacology •all psychoactive substances relevant to addiction, including alcohol, nicotine, caffeine, marijuana, opioids, stimulants and other prescription and illicit substances •diagnosis •neuroimaging techniques •treatment of special populations •treatment, early intervention and prevention of alcohol and drug use disorders •methodological issues in addiction research •pain and addiction, prescription drug use disorder •co-occurring addiction, medical and psychiatric disorders •pathological gambling disorder, sexual and other behavioral addictions •pathophysiology of addiction •behavioral and pharmacological treatments •issues in graduate medical education •recovery •health services delivery •ethical, legal and liability issues in addiction medicine practice •drug testing •self- and mutual-help.
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