Thrice-weekly versus daily buprenorphine maintenance.
BACKGROUND
Buprenorphine is a promising alternative to methadone or levo-acetyl alpha methadol for opioid agonist maintenance treatment, and thrice-weekly dosing would facilitate its use for this purpose.


METHODS
After a 3-day induction, opioid-dependent patients (n = 92) were randomly assigned to daily clinic attendance and 12-weeks maintenance treatment with sublingual buprenorphine administered double blind either daily (n = 45; 16 mg/70 kg) or thrice weekly (n = 47; 34 mg/70 kg on Fridays and Sundays and 44 mg/70 kg on Tuesdays). Outcome measures include retention, results of 3x/week urine toxicology tests, and weekly self-reported illicit drug use.


RESULTS
There were no significant differences at baseline in important social, demographic, and drug-use features. Retention was 71% in the daily and 77% in the 3x/week conditions. The proportion of opioid-positive urine tests decreased significantly from baseline in both groups and averaged 57% (daily) and 58% in 3x/week. There were no significant differences between groups in self-reported number of bags of heroin used for any day of the week, including Thursdays (48-72 hours following the last buprenorphine dose for subjects in the 3x/week condition), or in medication compliance (92%, 91%) and counseling attendance (82%, 82%).


CONCLUSIONS
At an equivalent weekly dose of 112 mg/70 kg, thrice-weekly and daily sublingual buprenorphine appear comparable in efficacy with regard to retention and reductions in illicit opioid and other drug use. These findings support the potential for utilizing thrice-weekly buprenorphine dosing in novel settings.
Schottenfeld
R S
RS
Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, USA.
Pakes
J
J
O'Connor
P
P
Chawarski
M
M
Oliveto
A
A
Kosten
T R
TR
D000328:Adult; D002047:Buprenorphine / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D019970:Cocaine-Related Disorders / Q000523:psychology / Q000534:rehabilitation; D004311:Double-Blind Method; D005260:Female; D006556:Heroin Dependence / Q000523:psychology / Q000534:rehabilitation; D006801:Humans; D008297:Male; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D011569:Psychiatric Status Rating Scales
D009292:Narcotic Antagonists; D002047:Buprenorphine