ACEP E-QUAL 36: Buprenorphine After Opiate Overdose Part 2

<p style="text-align:left;">This is part 2 of a 2 part discussion with Dr. Andrew Herring on the use of Buprenorphine after an opiate overdose, primarily in the ED. </p> <p style="text-align:left;">Guest: Andrew Herring MD (Associate Director of Research, Highland Hospital, Alameda Health System; Medical Director, Substance Use Disorder Treatment Program; Assistant Clinical Professor, UCSF)</p> <p style="text-align:center;">Host: Dr. Jason Woods; Podcast Sound Engineer: Kellen Vu</p> <p style="text-align:center;"><a href='http://www.acep.org/equal'>www.acep.org/equal</a></p> <p style="text-align:left;">References: </p> <ol><li style="text-align:left;">Weiner, Scott, et al. One-Year Mortality of Patients After Emergency Department Treatment for Nonfatal Opioid Overdose. Annals of Emergency Medicine. April 2, 2019. doi.org/10.1016/j.annemergmed.2019.04.020 </li> <li style="text-align:left;">Walsh SL, Preston KL, Stitzer ML, Cone EJ, Bigelow GE. Clinical pharmacology of buprenorphine: ceiling effects at high doses. Clin Pharmacol Ther. 1994;55(5):569-580. doi.org/10.1038/clpt.1994.71 </li> <li style="text-align:left;">Dahan A, Yassen A, Romberg R, et al. Buprenorphine induces ceiling in respiratory depression but not in analgesia. Br J Anaesth. 2006;96(5):627-632. doi.org/10.1093/bja/ael051 </li> <li style="text-align:left;">Ciraulo DA, Hitzemann RJ, Somoza E, et al. Pharmacokinetics and pharmacodynamics of multiple sublingual buprenorphine tablets in dose-escalation trials. J Clin Pharmacol. 2006;46(2):179-192. doi.org/10.1177/0091270005284192 </li> <li style="text-align:left;">Ang-Lee K, Oreskovich MR, Saxon AJ, et al. Single dose of 24 milligrams of buprenorphine for heroin detoxification: an open-label study of five inpatients. J Psychoactive Drugs. 2006;38(4):505-512. doi.org/10.1080/02791072.2006.10400589 </li> <li style="text-align:left;">Wang D, Sun X, Sadee W. Different effects of opioid antagonists on mu-, delta-, and kappa-opioid receptors with and without agonist pretreatment. J Pharmacol Exp T