Remote buprenorphine-naloxone initiation as an essential service for people with chronic pain and opioid dependence during the COVID-19 pandemic: Case reports, clinical pathways, and implications for the future

References

• Shanthanna H, Strand NH, Provenzano DA, Lobo CA, Eldabe S, Bhatia A, Wegener J, Curtis K, Cohen SP, Narouze S. Caring for patients with pain during the COVID-19 pandemic: consensus recommendations from an international expert panel. Anaesthesia. 2020;75(7):935–44. doi:10.1111/anae.15076.
   PubMed Web of Science ®Google Scholar
• Clarke H, Azargive S, Montbriand J, Nicholls J, Sutherland A, Valeeva L, Boulis S, McMillan K, Ladak SSJ, Ladha K. Opioid weaning and pain management in postsurgical patients at the Toronto General Hospital Transitional Pain Service. Canadian J Pain. 2018;2(1):236–47. doi:10.1080/24740527.2018.1501669.
   Web of Science ®Google Scholar
• Volkin S How has COVID-19 impacted supply chains around the world? Johns Hopkins University; Published 2020. https://hub.jhu.edu/2020/04/06/goker-aydin-global-supply-chain/.
   Google Scholar
• Clarke H, Abdool I 4 crucial health-care lessons Canada needs to learn from COVID-19. CBC News; Published 2020 [ Accessed 2020 Apr. 5]. https://www.cbc.ca/news/opinion/opinion-canada-health-care-covid-19-1.5510548.
   Google Scholar
• Struminger BB, Arora S. Leveraging telehealth to improve health care access in Rural America: it takes more than bandwidth. Ann Intern Med. 2019;171(5):376–77. doi:10.7326/M19-1200.
   Web of Science ®Google Scholar
• Saligram S, Bielefeldt K. The two sides of opioids in cyclical vomiting syndrome. N Am J Med Sci. 2014;6(3):114–18. doi:10.4103/1947-2714.128472.
   Google Scholar
• Wesson DR, Ling W. The Clinical Opiate Withdrawal Scale (COWS). J Psychoactive Drugs. 2003;35(2):253–59. doi:10.1080/02791072.2003.10400007.
   PubMed Web of Science ®Google Scholar
• Hammig R, Kemter A, Strasser J, Strasser J, von Bardeleben U, Gugger B, Walter M, Dürsteler K. Use of microdoses for induction of buprenorphine treatment with overlapping full opioid agonist use: the “Bernese method”. Subst Abuse Rehabil. 2016;7:99–105. doi:10.2147/SAR.S109919.
   PubMed Web of Science ®Google Scholar
• Kornfeld H, Reetz H. Transdermal buprenorphine, opioid rotation to sublingual buprenorphine, and the avoidance of precipitated withdrawal: a review of the literature and demonstration in three chronic pain patients treated with butrans. Am J Ther. 2015;22(3):199–205. doi:10.1097/MJT.0b013e31828bfb6e.
   PubMed Web of Science ®Google Scholar
• Raheemullah A, Lembke A. Buprenorphine induction without opioid withdrawal: a case series of 15 opioid-dependent inpatients induced on buprenorphine using microdoses of transdermal buprenorphine. Am J Ther. 2019. doi:10.1097/MJT.0000000000001108.
   Google Scholar
• Klaire S, Zivanovic R, Barbic SP, Sandhu R, Mathew N, Azar P. Rapid micro-induction of buprenorphine/naloxone for opioid use disorder in an inpatient setting: a case series. Am J Addict. 2019;28(4):262–65. doi:10.1111/ajad.12869.
   PubMed Web of Science ®Google Scholar
• Lee DS, Hann JE, Klaire SS, Nikoo M, Negraeff MD, Rezazadeh-Azar P. Rapid induction of buprenorphine/naloxone for chronic pain using a microdosing regimen: a case report. A A Pract. 2020;14(2):44–47. doi:10.1213/XAA.0000000000001138.
   PubMed Web of Science ®Google Scholar
• Canada H. Subsection 56(1)class exemption for patients, practitioners and pharmacists prescribing and providing controlled substances in Canada during the coronavirus pandemic; Published 2020 [ Accessed 2020 Apr.]. https://www.canada.ca/en/health-canada/services/health-concerns/controlled-substances-precursor-chemicals/policy-regulations/policy-documents/section-56-1-class-exemption-patients-pharmacists-practitioners-controlled-substances-covid-19-pandemic.html.
   Google Scholar
• Strosahl KD, Robinson PJ, GUstavsson T. Brief interventions for radical change: principles and practice of focused acceptance and commitment therapy. Oakland (CA): New Harbinger Publications; 2012.
   Google Scholar
• Polk KL, Benjamin S, Webster M, Olaz FO. The essential guide to the ACT Matrix: a step-by-step approach to using the ACT Matrix model in clinical practice. Oakland (CA): New Harbinger Publications; 2016.
   Google Scholar
• Linehan M. DBT skills training manual. 2nd ed. New York (NY): Guilford Press; 2014.
   Google Scholar
• Jensen MP. Hypnosis for chronic pain management: a new hope. Pain. 2009;146(3):235–37. doi:10.1016/j.pain.2009.06.027.
   PubMed Web of Science ®Google Scholar
• Vasant DH, Whorwell PJ. Gut-focused hypnotherapy for Functional Gastrointestinal Disorders: evidence-base, practical aspects, and the Manchester Protocol. Neurogastroenterol Motil. 2019;31(8):e13573. doi:10.1111/nmo.13573.
   PubMed Web of Science ®Google Scholar
• Palsson OS. Hypnosis treatment of gastrointestinal disorders: a comprehensive review of the empirical evidence. Am J Clin Hypn. 2015;58(2):134–58. doi:10.1080/00029157.2015.1039114.
   PubMed Web of Science ®Google Scholar
• Rivat C, Ballantyne J. The dark side of opioids in pain management: basic science explains clinical observation. Pain Rep. 2016;1(2):e570. doi:10.1097/PR9.0000000000000570.
   Google Scholar
• Weinrib AZ, Burns LC, Mu A, Azam MA, Ladak SSJ, McRae K, Katznelson R, Azargive S, Tran C, Katz J. A case report on the treatment of complex chronic pain and opioid dependence by a multidisciplinary transitional pain service using the ACT Matrix and buprenorphine/naloxone. J Pain Res. 2017;10:747–55. doi:10.2147/JPR.S124566.
   Web of Science ®Google Scholar
• Smirnov A, Kemp R. Use and misuse of opioid replacement therapies: a Queensland study. Subst Use Misuse. 2012;47(1):78–85. doi:10.3109/10826084.2011.629017.
   PubMed Web of Science ®Google Scholar
• Bruneau J, Ahamad K, Goyer ME, Poulin G, Selby P, Fischer B, Wild TC, Wood E. Management of opioid use disorders: a national clinical practice guideline. CMAJ. 2018;190(9):E247–E257. doi:10.1503/cmaj.170958.
   PubMed Web of Science ®Google Scholar
• Michael ES, Burns JW. Catastrophizing and pain sensitivity among chronic pain patients: moderating effects of sensory and affect focus. Ann Behav Med. 2004;27(3):185–94. doi:10.1207/s15324796abm2703_6.
   PubMed Web of Science ®Google Scholar
• Vowles KE, McCracken LM, O’Brien JZ. Acceptance and values-based action in chronic pain: a three-year follow-up analysis of treatment effectiveness and process. Behaviour Research and Therapy. 2011;49(11):748–55. doi:10.1016/j.brat.2011.08.002.
   PubMed Web of Science ®Google Scholar
• Caddy P, Smith K. A quick-reference guide for prescribing buprenorphine/naloxone (Suboxone) in the outpatient setting. BC Med J. 2018;60:392–97.
   Web of Science ®Google Scholar
• Lee JD, Grossman E, DiRocco D, Gourevitch MN. Home buprenorphine/naloxone induction in primary care. J Gen Intern Med. 2009;24(2):226–32. doi:10.1007/s11606-008-0866-8.
   PubMed Web of Science ®Google Scholar
• Lee JD, Vocci F, Fiellin DA. Unobserved “home” induction onto buprenorphine. J Addict Med. 2014;8(5):299–308. doi:10.1097/ADM.0000000000000059.
   PubMed Web of Science ®Google Scholar
• Sohler NL, Li X, Kunins HV, Sacajiu G, Giovanniello A, Whitley S, Cunningham CO. Home- versus office-based buprenorphine inductions for opioid-dependent patients. J Subst Abuse Treat. 2010;38(2):153–59. doi:10.1016/j.jsat.2009.08.001.
   PubMed Web of Science ®Google Scholar
• Amass L, Kamien JB, Mikulich SK. Thrice-weekly supervised dosing with the combination buprenorphine-naloxone tablet is preferred to daily supervised dosing by opioid-dependent humans. Drug Alcohol Depend. 2001;61(2):173–81. doi:10.1016/S0376-8716(00)00141-1.
   PubMed Web of Science ®Google Scholar
• Bell J, Shanahan M, Mutch C, Rea F, Ryan A, Batey R, Dunlop A, Winstock A. A randomized trial of effectiveness and cost-effectiveness of observed versus unobserved administration of buprenorphine-naloxone for heroin dependence. Addiction. 2007;102(12):1899–907. doi:10.1111/j.1360-0443.2007.01979.x.
   PubMed Web of Science ®Google Scholar
• Handelsman L, Cochrane KJ, Aronson MJ, Ness R, Rubinstein KJ, Kanof PD. Two new rating scales for opiate withdrawal. Am J Drug Alcohol Abuse. 1987;13(3):293–308. doi:10.3109/00952998709001515.
   PubMed Web of Science ®Google Scholar
• Eccleston C, Blyth FM, Dear BF, Fisher EA, Keefe FJ, Lynch ME, Palermo TM, Reid MC, Williams ACDC. Managing patients with chronic pain during the Covid-19 outbreak: considerations for the rapid introduction of remotely supported (e-health) pain management services. Pain. 2020;161(5):889–93. doi:10.1097/j.pain.0000000000001885.
   PubMed Web of Science ®Google Scholar
• Weinrib A, Azam MA, Latman V, Janmohamed T, Clarke H, Katz J. Manage my pain: a patient-driven mobile platform to prevent & manage chronic postsurgical pain. In: El Morr C, editor. Novel applications of virtual communities in healthcare. Hershey (PA): IGI Global. 2017. p. 93–126.
   Google Scholar
• Nicholls JL, Azam MA, Burns LC, Englesakis M, Sutherland AM, Weinrib AZ, Katz J, Clarke H. Psychological treatments for the management of postsurgical pain: a systematic review of randomized controlled trials. Patient Relat Outcome Meas. 2018;9:49–64. doi:10.2147/PROM.S121251.
   PubMed Web of Science ®Google Scholar
• Weinrib AZ, Azam MA, Birnie KA, Burns LC, Clarke H, Katz J. The psychology of chronic post-surgical pain: new frontiers in risk factor identification, prevention and management. Br J Pain. 2017;11(4):169–77. doi:10.1177/2049463717720636.
   PubMed Web of Science ®Google Scholar
• Frank JW, Lovejoy TI, Becker WC, Morasco BJ, Koenig CJ, Hoffecker L, Dischinger HR, Dobscha SK, Krebs EE. Patient outcomes in dose reduction or discontinuation of long-term opioid therapy: a systematic review. Ann Intern Med. 2017;167(3):181–91. doi:10.7326/M17-0598.
   PubMed Web of Science ®Google Scholar
• Koppert W, Ihmsen H, Korber N, Wehrfritz A, Sittl R, Schmelz M, Schüttler J. Different profiles of buprenorphine-induced analgesia and antihyperalgesia in a human pain model. Pain. 2005;118(1–2):15–22. doi:10.1016/j.pain.2005.06.030.
   PubMed Web of Science ®Google Scholar
• Weiner M, Sarantopoulos C, Gordon E. Transdermal buprenorphine controls central neuropathic pain. J Opioid Manag. 2012;8(6):414–15. doi:10.5055/jom.2012.0141.
   Google Scholar
• Ossipov MH, Lai J, Vanderah TW, Porreca F. Induction of pain facilitation by sustained opioid exposure: relationship to opioid antinociceptive tolerance. Life Sci. 2003;73(6):783–800. doi:10.1016/S0024-3205(03)00410-7.
   Web of Science ®Google Scholar
• Sansone RA, Sansone LA. Chronic pain syndromes and borderline personality. Innov Clin Neurosci. 2012;9:10–14.
   PubMedGoogle Scholar