title: A preliminary investigation of outcome following gradual or rapid buprenorphine detoxification.
abstract: Eight opioid-dependent individuals were maintained on daily sublingual buprenorphine (8 mg) for 28 days and assigned randomly to one of two outpatient detoxification schedules under double-blind, double-dummy conditions. The two detoxification schedules were buprenorphine gradual (36 days; N = 3) or buprenorphine rapid (12 days; N = 5). Outcome variables were subject- and observer-ratings of opioid withdrawal, treatment retention and illicit-opioid use. Outcome measures were similar for the two groups during buprenorphine maintenance. Increases in subject-rated opioid withdrawal and illicit-opioid use, and a drop in treatment retention occurred during rapid detoxification. Stable subject-rated opioid withdrawal and treatment retention, and less illicit-opioid use occurred during gradual detoxification. These data suggest that gradual reduction in buprenorphine dose is likely to produce superior treatment outcomes than more rapid buprenorphine detoxification.
authors.affiliation: Department of Psychiatry, University of Vermont, Burlington 05401, USA.
authors.forename: L
authors.initials: L
authors.lastname: Amass
authors.forename: W K
authors.initials: WK
authors.lastname: Bickel
authors.forename: S T
authors.initials: ST
authors.lastname: Higgins
authors.forename: J R
authors.initials: JR
authors.lastname: Hughes
mesh_terms: D000286:Administration, Sublingual; D000328:Adult; D002047:Buprenorphine / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009460:Neurologic Examination / Q000187:drug effects; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D010349:Patient Compliance / Q000523:psychology; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis; D016896:Treatment Outcome
chemical_list: D002047:Buprenorphine