User:Llzhao/sandbox

The most common side effects (in order of most common to least common) of sublingual tablets include: headaches, withdrawal syndrome, pain, diaphoresis, vasodilatation, and vomiting. The most common side effects seen in film formulations are glossodynia, oral hypoesthesia, and oral mucosa erythema. Serious adverse effects include hepatitis, anaphylaxis, CNS depression, respiratory depression, drug dependence, and serotonin syndrome.

The following drugs must be avoided in combination with Suboxone (Risk category X) :

1.      Enhancing the CNS depressant effects of either buprenorphine or the drug itself: azelastine (nasal), orphenadrine, oxomemazine, paraldehyde, thalidomide

2.      Altering the concentration or metabolism of CYP3A4 substrates (high risk with inducers and inhibitors) and/or buprenorphine: conivaptan, idelalisib, fusidic acid

3.      Opioids (mixed agonist or antagonist) that could decrease the therapeutic effect of buprenorphine, or cause opioid withdrawal: methylnaltrexone, naloxegol, MAOi’s

4.      Opioid analgesics (mixed agonist or antagonist) will have decreased analgesic effects in combination with Suboxone: eluxadoline

5.      Atazanavir serum levels may decrease while buprenorphine serum levels increase

Other drugs that fall in the above drug classes should be used with caution followed by close monitoring and/or change in therapy.

President Trump addressed the opioid epidemic on 10/26/17 and called it a public health emergency. Besides urging head of agencies to reduce the number of deaths caused by the crisis, his administration also plans to target youth via advertisements to highlight the "devastation and ruination" of opioids. However, President Trump did not declare this as a national emergency under the Public Health Service Act or the Stafford act, which limits funding and access to treatment. Funding is a big concern; the Public Health Emergency Fund is nearly empty and there is a proposal by the Trump administration to cut funding in 2018 for the Substance Abuse and Mental Health Services Administration, which is in charge of addiction treatment programs under the Department of Health and Human Services.