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Buprenorphine: a guide for nurses.

Azimi-Bolourian S., Fornili K.
[US] Substance Abuse and Mental Health Services Administration, 2009.
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Comprehensive guide from the US health department’s substance use treatment authority for nurses involved in buprenorphine-based treatment for dependence on opiate-type drugs like heroin, including detoxification and substitute prescribing.

Summary This guide from the US health department’s substance use treatment authority is intended to provide nurses with general information about buprenorphine products (including the combination of buprenorphine and naloxone marketed as Suboxone), with a view to improving treatment outcomes for patients receiving treatment for dependence on opioid drugs (opiate-type drugs like heroin). Buprenorphine medications are commonly used to aid withdrawal from opioids, and on a long-term maintenance basis as a safer substitute for illegal opioids.

Report cover: click to download full report

The guide can serve as a resource for specialist nurses in substance use services and for those working with general practitioners and in other community settings. As well as comprehensive guidance, it includes reproducible resources such as screening and assessment questionnaires and schedules to identify and diagnose substance use and mental health problems, treatment process flowcharts, and dosing schedules.

The intention is that the guidance will fulfil the following learning objectives:
• Provide nurses with general information on the pharmacology, safety profile, adverse effects, interactions, cautions, contraindications, and abuse potential of buprenorphine products.
• Increase nurses’ factual knowledge on protocols for the use of buprenorphine products in medically supervised withdrawal (detoxification) and maintenance treatment services.
• Help nurses, in conjunction with physicians, design strategies for providing comprehensive physical and psychosocial assessments, treatment monitoring, and appropriate referral for opioid addiction and co-occurring medical and psychiatric conditions.
• Provide comprehensive and practical guidance for patient screening, assessment, starting treatment and the early induction phase, stabilisation, and preventing buprenorphine causing sudden withdrawal symptoms by displacing stronger opiate-type drugs from neural receptors in the body.
• Educate nurses about effective communication, assessing patients’ readiness to change, and appropriate motivational enhancement interventions to ensure that counselling is delivered concurrently with pharmacological interventions.
• Enhance addiction recovery management by educating nurses about stigma, patient empowerment, how medical staff and patients can work towards recovery in partnership, evidence-based practices, the application of technology, and the importance of ongoing patient monitoring and support.

Last revised 22 October 2015. First uploaded 22 October 2015

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