title: Well-being, psychosocial factors, and side-effects among heroin-dependent inpatients after detoxification using buprenorphine versus clonidine.
abstract: Previous studies comparing buprenorphine and clonidine provided little information about subjective factors associated with the effective management of opioid withdrawal. This study sought to compare detoxification programs using these medications with regard to side-effects and related distress, general well-being, perceived self-efficacy and social support. A total of 200 treatment-seeking heroin-dependent patients, aged 18-50, were randomly assigned to buprenorphine or clonidine inpatient withdrawal treatments over 10days followed by 11days of relapse prevention measures. A semi-structured interview and a battery of self-rating scales assessing parameters of the interest were administered to the patients who completed the 10-day detoxification protocol with buprenorphine (n=90) and clonidine (n=50). Chi-square statistics and analysis of covariance were performed to examine between-group differences. Compared with patients treated with clonidine, patients who received buprenorphine developed significantly less side-effects and related distress, and had higher senses of well-being, self-efficacy and social support. The findings suggest that buprenorphine is preferable for inpatient detoxification due to its side-effects profile and positive effects on well-being and psychosocial variables. These early benefits of buprenorphine could enable consequent maintenance treatment.
authors.affiliation: Mental Health Services, Ministry of Health, 2 Ben Tabai St., Jerusalem, 93591, Israel. alexander.ponizovsky@moh.health.gov.il <alexander.ponizovsky@moh.health.gov.il>
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Ponizovsky
authors.forename: Alexander
authors.initials: A
authors.lastname: Grinshpoon
authors.forename: Anatoly
authors.initials: A
authors.lastname: Margolis
authors.forename: Rami
authors.initials: R
authors.lastname: Cohen
authors.forename: Paula
authors.initials: P
authors.lastname: Rosca
mesh_terms: D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use; D002047:Buprenorphine / Q000009:adverse effects / Q000627:therapeutic use*; D003000:Clonidine / Q000009:adverse effects / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006556:Heroin Dependence / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020377:Self Efficacy; D012944:Social Support; D013375:Substance Withdrawal Syndrome / Q000523:psychology
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D002047:Buprenorphine; D003000:Clonidine