Switching to Buprenorphine Might Provide Pain Relief for Poorly Controlled Pain

PainRelief.com Interview with:
Victoria D. Powell, MD, FACP
Clinical Lecturer – Geriatric and Palliative Medicine
University of Michigan
Staff Physician, Palliative Care
LTC Charles S. Kettles VA Medical Center
Ann Arbor, MI

Dr. Powell

PainRelief.com:  What is the background for this study?  What are the main findings?

Response: People with chronic pain who use long-term opioids face a number of health risks, and often do not have optimally controlled pain.

Buprenorphine acts on the opioid receptor with a different effect than drugs like morphine or oxycodone, and as a result is less associated with the risks of long-term opioid use, such as accidental overdose. While buprenorphine has been successfully used in patients with opioid use disorder for several years, certain experts have proposed using buprenorphine for pain management in people with chronic pain. We found low quality evidence supporting pain control that may be superior to traditional opioids, but much more research is needed to confirm.

PainRelief.com: What should readers take away from your report?

Response: Switching to buprenorphine to help control pain might be an option if a patient is having poorly controlled pain or severe side effects with traditional opioids. 

PainRelief.com: What recommendations do you have for future research as a result of this work?

Response: It is not clear how best to transition someone with chronic pain using long-term opioids onto buprenorphine, or what form of buprenorphine works best (for example, patch or buccal/sublingual, with or without naloxone). We also need to know more about how buprenorphine affects important mental health outcomes, like depression, anxiety, and PTSD symptoms. 

No disclosures.

Citation:

Powell VD, Rosenberg JM, Yaganti A, et al. Evaluation of Buprenorphine Rotation in Patients Receiving Long-term Opioids for Chronic Pain: A Systematic Review. JAMA Netw Open. 2021;4(9):e2124152. doi:10.1001/jamanetworkopen.2021.24152

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