Email Service Notes 2nd September (Raph)

Original:
The misuse of prescribed and OTC codeine raised great public concerns due to the increased the risk of typical side effects, mortality and psychiatric co-morbidity. There was an increasing evidence base of cases demonstrated that Buprenorphine/naloxone treatment was associated with successful treatment outcome with a positive safety profile. In addition, it was easier for patients with buprenorphine/naloxone treatment transfer into opioid agonist treatment compared with methadone. The objective of this review was to collect clinical case presentation literature on the use of buprenorphine/naloxone in codeine dependence treatment.
Methods: The author presented a scope review by conducting a comprehensive search within databases: Science Direct, EBSCO Host, PsychINFO, and PubMED. At last, 7 cases presentation records from 2014 to 2015 on buprenorophien/naloxone for codeine dependence treatment were identified from 5535 articles. Five themes as follows were analyzed: (1) Patient Profiles; (2) History of Codeine Misuse; (3) Medical Problems; (4) Use of Other Substances; and (5) Buprenorphine-naloxone in the treatment of Codeine Dependence.
Results: A growing number of the patients had a history of codeine misuse or diversion which induced complicated medical complication such as constipation, withdrawal symptoms etc. Additionally, other substances were concurrently used with codeine. Buprenorphine/naloxone treatment was more common than methadone to be used for codeine dependence treatment.
The duration of buprenorphine/naloxone treatment ranged from 1 month to 11 months and dosage from 2 mg to 24 mg. Psychosocial treatments were also provided at the same time in some studies.
Discussion: The scope review highlighted the complexities of codeine dependent patients with regarding to pain, psychiatric disease and poly substance use. Buprenorphine-naloxone was encouraged to be used for patients in terms of stabilization and recovery.

Edited:
The misuse of prescribed and OTC Codeine raises great public concerns, due to the increased the risk of typical side effects, mortality and psychiatric co-morbidity. Increasing evidence based on case studies have demonstrated that the use of Buprenorphine/Naloxone is associated with successful treatment outcomes, with a positive safety profile. In addition, these cases have shown that it was easier for patients who were on Buprenorphine/Naloxone treatments to transfer into agonist opioid treatments, compared with patients who were on Methadone. The objective of this review was to collect clinical case presentation literature on the use of Buprenorphine/Naloxone in the treatment of Codeine dependence.
Methods: The author presented a scope review by conducting a comprehensive search within Science Direct, EBSCO Host, PsychINFO, and PubMED databases. At last, 7 case presentations records from 2014 to 2015 on Buprenorophien/Naloxone use in the treatment of codeine dependence were identified from 5535 articles. Five themes were analyzed: (1) Patient Profiles; (2) History of Codeine Misuse; (3) Medical Problems; (4) Use of Other Substances; and (5) Buprenorphine-Naloxone in the treatment of Codeine Dependence.
Results: A growing number of the patients had a history of codeine misuse or diversion, which induced serious medical complications, such as constipation, withdrawal symptoms etc. Additionally, other substances were concurrently used with codeine. Buprenorphine/Naloxone treatment was more commonly used than Methadone for the treatment of Codeine dependence.
The duration of the Buprenorphine/Naloxone treatments ranged from 1 to 11 months and dosage from 2 to 24 mg. In some studies, psychosocial treatments were also provided at the same time.
Discussion: The scope review highlighted the complexities in regarding to pain, psychiatric disease and polysubstance use in Codeine-dependent patients . Buprenorphine-Naloxone was encouraged to be used for patients in terms of stabilization and recovery.