Assessment and management of opioid withdrawal symptoms in buprenorphine-dependent subjects.
The spontaneous physical dependence of buprenorphine was assessed in opioid addicts who switched from heroin to sublingual or intravenous buprenorphine. Twenty-two patients were randomly assigned to double-blind administration of methadone (n = 11) or placebo (n = 11) for 13 days after abrupt withdrawal of buprenorphine. Methadone was administered according to four pre-established dosing schedules depending on the previous amount of daily consumed buprenorphine. No methadone-treated patient required modification of the therapeutic regimen, whereas eight of eleven placebo-treated patients needed treatment with methadone. Buprenorphine withdrawal syndrome was of opioid type, began somewhat more slowly, and showed a peak until day 5. The occurrence, time-course and characteristics of buprenorphine withdrawal syndrome make it necessary to reconsider the abuse potential of this analgesic.
San
L
L
Sección de Toxicomanias, Hospital del Mar, Barcelona, Spain.
Camí
J
J
Fernández
T
T
Ollé
J M
JM
Peri
J M
JM
Torrens
M
M
D000328:Adult; D002047:Buprenorphine / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006556:Heroin Dependence / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D009460:Neurologic Examination / Q000187:drug effects; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D016320:Substance Abuse Treatment Centers; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis*
D002047:Buprenorphine; D008691:Methadone