Two methods of community detoxification from opiates: an open-label comparison of lofexidine and buprenorphine.
There is currently no consensus on the best approach to the management of opiate detoxification. In the current open-label study, 69 opiate-dependent individuals requesting outpatient detoxification were allocated to two different medication regimes: lofexidine and buprenorphine. Allocation was dependent on the timing of their presentation. Lofexifidine is a structural analogue of clonidine, and used widely in the UK. Buprenorphine is a partial opiate agonist with unusual pharmacological properties. Outcomes were better for the buprenorphine-receiving group (n=38). Clients receiving buprenorphine had a less severe withdrawal syndrome, and were more likely to complete their detoxification. In addition, for the buprenorphine-receiving group it was found that the withdrawal syndrome was least in those prescribed an initial dose of 4 mg. The findings and their implications are discussed. The design of the study precludes definitive conclusions regarding relative efficacy.
White
R
R
St Lukes Woodside Hospital, Woodside Avenue, Muswell Hill, N10 3HU, London, UK. rupert.white@virgin.net
Alcorn
R
R
Feinmann
C
C
D000328:Adult; D002047:Buprenorphine / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D003000:Clonidine / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D003153:Community Health Services / Q000379:methods*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy*
D009292:Narcotic Antagonists; D002047:Buprenorphine; D003000:Clonidine; C025655:lofexidine