000			04157nam a22005177a 4500
008			210726s20212021 xxu||||| |||| 00| 0 eng d
024			_a10.1016/j.ajem.2021.06.065 [doi]
024			_aS0735-6757(21)00551-9 [pii]
040			_aOvid MEDLINE(R)
099			_a34274576
245			_aA practical review of buprenorphine utilization for the emergency physician in the era of decreased prescribing restrictions. [Review]
251			_aAmerican Journal of Emergency Medicine. 48:316-322, 2021 10.
252			_aAm J Emerg Med. 48:316-322, 2021 10.
252			_zAm J Emerg Med. 48:316-322, 2021 Jul 05.
253			_aThe American journal of emergency medicine
260			_c2021
260			_fFY2022
260			_p2021 Jul 05
265			_saheadofprint
265			_sppublish
266			_d2021-07-26
268			_aAmerican Journal of Emergency Medicine. 48:316-322, 2021 Jul 05.
269			_fFY2022
501			_aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
520			_aCONCLUSION: Emergency physicians can influence opioid related morbidity and mortality, by familiarizing themselves with the use of buprenorphine to treat opioid withdrawal and addiction, particularly now that prescribing restrictions have been eased. Further ED research is necessary to assess the optimal use of buprenorphine in this care setting. Copyright (c) 2021 Elsevier Inc. All rights reserved.
520			_aDISCUSSION: Multiple studies have pointed to the effective use of buprenorphine as a treatment for OUDs in ED patients and are superior to standard care; however, there are various barriers to its use in the ED setting.
520			_aINTRODUCTION: Opioid abuse and overdose deaths have reached epidemic proportions in the last couple decades. In response to rational prescribing initiatives, utilization of prescription opioids has decreased; however, the number of deaths due to opioid overdoses continues to rise, largely driven by fentanyl analogues in adulterated heroin. Solutions to the opioid crisis must be multifaceted and address underlying opioid addiction. In recent years, buprenorphine has become a cornerstone in the treatment of opioid use disorder (OUD) and initiation of therapy in the emergency department (ED) has become increasingly common. There have also been calls by many organizations to remove the requirement for additional training and X-waiver to prescribe buprenorphine. In April 2021, the Biden Administration eased prescribing restrictions on the drug. These initiatives are expected to increase ED utilization of the buprenorphine. The purpose of this paper is to provide an updated overview of the role and use of buprenorphine in the ED setting so physicians may adapt to the changing practice environment.
520			_aOBJECTIVES: This is a narrative review describing the role of buprenorphine in the ED. A PubMed search was conducted using the keywords "opioid epidemic" "buprenorphine," and "medication assisted therapy", and "emergency department". All the articles that contained information on the opioid epidemic, medication assisted therapy, and the biological effects of buprenorphine, that were also relevant to pain management and the ED, were included in the review.
546			_aEnglish
650			_a*Analgesics, Opioid/tu [Therapeutic Use]
650			_a*Buprenorphine, Naloxone Drug Combination/tu [Therapeutic Use]
650			_a*Buprenorphine/tu [Therapeutic Use]
650			_a*Emergency Medicine
650			_a*Opiate Substitution Treatment/mt [Methods]
650			_a*Opioid-Related Disorders/dt [Drug Therapy]
650			_aDrug and Narcotic Control/lj [Legislation & Jurisprudence]
650			_aHumans
651			_aMedStar Washington Hospital Center
656			_aEmergency Medicine
657			_aJournal Article
657			_aReview
700			_aAmirshahi, Maryann
790			_aBeisenova K, Mazer-Amirshahi M, Mortimer N, Pourmand A, Shukur N, Tebo C
856			_uhttps://dx.doi.org/10.1016/j.ajem.2021.06.065 _zhttps://dx.doi.org/10.1016/j.ajem.2021.06.065
942			_cART _dArticle
999			_c6655 _d6655