Detoxification of opiate addicts with multiple drug abuse: a comparison of buprenorphine vs. methadone.
Over the last few years, there has been a growing tendency for opioid addicts to abuse multiple drugs, although many patients are in substitution therapy with methadone. Abuse of multiple drugs leads to a more complicated withdrawal syndrome; it is therefore necessary to investigate new drug strategies as a treatment for detoxification. Buprenorphine appears to be an effective and safe drug in opioid-addicted patient detoxification. In this study, we have compared the short-term efficacy of an 11-day low-dose buprenorphine/14-day carbamazepine regime [BPN/CBZ] (n = 14) to an 11-day methadone/14-day carbamazepine regime [MET/CBZ] (n = 12) in a double-dummy, randomized 14-day inpatient detoxification treatment study. Twenty-six inpatients met the DSM-IV criteria for opioid dependence and were included in this study. All patients abused various additional drugs. Fourteen of 26 patients (53.8 %) completed the study. Seven non-completers (seven of 12 = 58.3 %) were treated with methadone/carbamazepine and five non-completers (five of 14 = 35.7 %) received buprenorphine/carbamazepine, but the difference in the dropout rate was not significant. However, patients with buprenorphine/carbamazepine showed significantly fewer withdrawal symptoms after the first two weeks of treatment. The present study supports the hypothesis that buprenorphine/carbamazepine is more effective than methadone/carbamazepine in detoxification strategies for opioid addict with additional multiple drug abuse. No severe side effects occurred during treatment in either group.
Seifert
J
J
Department of Clinical Psychiatry and Psychotherapy, Medical School, Hannover, Germany. Seifert.Juergen@mh-hannover.de
Metzner
C
C
Paetzold
W
W
Borsutzky
M
M
Passie
T
T
Rollnik
J
J
Wiese
B
B
Emrich
H M
HM
Schneider
U
U
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D002047:Buprenorphine / Q000008:administration & dosage / Q000627:therapeutic use*; D002220:Carbamazepine / Q000627:therapeutic use; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D009294:Narcotics / Q000008:administration & dosage / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D019966:Substance-Related Disorders / Q000188:drug therapy; D016896:Treatment Outcome
D000927:Anticonvulsants; D009292:Narcotic Antagonists; D009294:Narcotics; D002220:Carbamazepine; D002047:Buprenorphine; D008691:Methadone