title: A protocol to switch high-dose, methadone-maintained subjects to buprenorphine.
abstract: Buprenorphine (BUP) is an alternative to methadone (METH) maintenance. However, there are few studies on the switching of patients from METH to BUP. Eighteen volunteers who had been maintained on METH for 1-19 years were recruited for a residential cocaine self-administration study. All subjects were maintained on 60 mg METH for up to 1 1/2 weeks before the 7-day changeover (60, 40, 30, 30, 0 mg METH; 4, 8 mg BUP). Fifteen subjects successfully completed the transfer from METH to BUP, experiencing moderate withdrawal symptoms, as measured by the Subjective Opiate Withdrawal Scale (SOWS). Withdrawal symptoms were the highest during the first assessment of the day, at the time of BUP administration. SOWS scores returned to baseline 4 days after the switchover. This study demonstrates that within a supportive inpatient setting, research volunteers can be rapidly switched from high-maintenance doses of METH to BUP with an acceptable degree of tolerability.
authors.affiliation: Department of Psychiatry, Columbia University/New York State Psychiatric Institute, New York 10032, USA.
authors.forename: F R
authors.initials: FR
authors.lastname: Levin
authors.forename: M W
authors.initials: MW
authors.lastname: Fischman
authors.forename: I
authors.initials: I
authors.lastname: Connerney
authors.forename: R W
authors.initials: RW
authors.lastname: Foltin
mesh_terms: D000328:Adult; D014151:Anti-Anxiety Agents / Q000008:administration & dosage; D001007:Anxiety / Q000188:drug therapy; D002047:Buprenorphine / Q000008:administration & dosage*; D003000:Clonidine / Q000008:administration & dosage; D003042:Cocaine; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008691:Methadone / Q000008:administration & dosage*; D009292:Narcotic Antagonists / Q000008:administration & dosage*; D009294:Narcotics / Q000008:administration & dosage*; D009293:Opioid-Related Disorders / Q000628:therapy*; D010076:Oxazepam / Q000008:administration & dosage; D016320:Substance Abuse Treatment Centers; D013375:Substance Withdrawal Syndrome / Q000503:physiopathology / Q000523:psychology; D013565:Sympatholytics / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D014151:Anti-Anxiety Agents; D009292:Narcotic Antagonists; D009294:Narcotics; D013565:Sympatholytics; D002047:Buprenorphine; D010076:Oxazepam; D003042:Cocaine; D003000:Clonidine; D008691:Methadone