title: Thrice-weekly supervised dosing with the combination buprenorphine-naloxone tablet is preferred to daily supervised dosing by opioid-dependent humans.
abstract: A sublingual tablet formulation of buprenorphine combining 8 mg of buprenorphine with 2 mg of naloxone is being targeted for use in settings where less than daily dosing strategies and/or prescription-based dispensing will likely be employed. This study determined patient preferences for, and clinical outcomes during, daily and 3-day per week supervised dosing schedules using the combination tablet. Twenty-four opioid-dependent subjects completing a 16-day baseline entered an outpatient triple crossover trial. Twenty-one days of daily dosing were compared to two different 21-day periods of 3-day per week supervised dosing: a 3-day per week clinic schedule and a 3-day per week take-home schedule in which tablets were provided to subjects to take at home on days between clinic visits. Thirteen patients completed the study. Significantly more doses were ingested under the 3-day per week schedules. Illicit drug use did not differ across conditions and 45% of urine samples tested positive for illicit opioids. Subjects 'liked' both 3-day per week schedules more than the daily schedule, and ratings of feeling 'good' were higher for the 3-day take-home as opposed to 3-day clinic condition. Almost all subjects (91%) rated 3-day take-home as the most preferred schedule. Overall, reducing clinic attendance improved medication compliance and increased client satisfaction without impacting illicit drug use.
authors.affiliation: Department of Psychiatry, University of Colorado School of Medicine, Vine Street Center, 1741 Vine Street, Denver, CO 80206, USA. lamass@friendsresearch.org
authors.forename: L
authors.initials: L
authors.lastname: Amass
authors.forename: J B
authors.initials: JB
authors.lastname: Kamien
authors.forename: S K
authors.initials: SK
authors.lastname: Mikulich
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002047:Buprenorphine / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009270:Naloxone / Q000008:administration & dosage*; D009292:Narcotic Antagonists / Q000008:administration & dosage*; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000523:psychology / Q000652:urine; D010349:Patient Compliance
chemical_list: D004338:Drug Combinations; D009292:Narcotic Antagonists; D009270:Naloxone; D002047:Buprenorphine