Extract
Preventing prescription opioid poisoning deaths is a major public health priority in Western societies. Deaths from these medications exceed deaths from all illicit drugs combined [1]. Methadone (for pain treatment) is involved in one third of US prescription opioid overdose deaths despite accounting for only 5% of dispensed opioids [2]. There is a dose-dependent increase in the severity of central sleep apnoea (CSA) with methadone [3–5] and sleep disordered breathing is a contributing factor in methadone-related deaths [2]. The partial μ-agonist buprenorphine is putatively safer than methadone with a ceiling effect upon respiratory depression [6]. However, the effect of buprenorphine on breathing during sleep remains unclear. The only relevant report from a cross-sectional observational study suggested that buprenorphine-naloxone therapy may induce significant CSA and hypoxaemia [7].
Abstract
Methadone-using patients with central sleep apnoea may reverse symptoms with switch to buprenorphine-naloxone therapy http://ow.ly/NilUq
Footnotes
Support statement: D. Wang is supported by an Australian National Health and Medical Research Council (NHMRC) Project Grant (1043633). R.R. Grunstein is supported by an NHMRC Practitioner Fellowship (1022730). Funding information for this article has been deposited with FundRef.
Conflict of interest: Disclosures can be found alongside the online version of this article at erj.ersjournals.com
- Received March 30, 2015.
- Accepted April 29, 2015.
- Copyright ©ERS 2015