A preliminary investigation of outcome following gradual or rapid buprenorphine detoxification.
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.
Amass
L
L
Department of Psychiatry, University of Vermont, Burlington 05401, USA.
Bickel
W K
WK
Higgins
S T
ST
Hughes
J R
JR
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
D002047:Buprenorphine