Buprenorphine tapering schedule and illicit opioid use.
OBJECTIVE
To compare the effects of a short or long taper schedule after buprenorphine stabilization on participant outcomes as measured by opioid-free urine tests at the end of each taper period.


METHODS
This multi-site study sponsored by Clinical Trials Network (CTN, a branch of the US National Institute on Drug Abuse) was conducted from 2003 to 2005 to compare two taper conditions (7 days and 28 days). Data were collected at weekly clinic visits to the end of the taper periods, and at 1-month and 3-month post-taper follow-up visits.


METHODS
Eleven out-patient treatment programs in 10 US cities.


METHODS
Non-blinded dosing with Suboxone during the 1-month stabilization phase included 3 weeks of flexible dosing as determined appropriate by the study physicians. A fixed dose was required for the final week before beginning the taper phase.


METHODS
The percentage of participants in each taper group providing urine samples free of illicit opioids at the end of the taper and at follow-up.


RESULTS
At the end of the taper, 44% of the 7-day taper group (n = 255) provided opioid-free urine specimens compared to 30% of the 28-day taper group (n = 261; P = 0.0007). There were no differences at the 1-month and 3-month follow-ups (7-day = 18% and 12%; 28-day = 18% and 13%, 1 month and 3 months, respectively).


CONCLUSIONS
For individuals terminating buprenorphine pharmacotherapy for opioid dependence, there appears to be no advantage in prolonging the duration of taper.
Ling
Walter
W
University of California, Los Angeles, CA 90025, USA.
Hillhouse
Maureen
M
Domier
Catherine
C
Doraimani
Geetha
G
Hunter
Jeremy
J
Thomas
Christie
C
Jenkins
Jessica
J
Hasson
Albert
A
Annon
Jeffrey
J
Saxon
Andrew
A
Selzer
Jeffrey
J
Boverman
Joshua
J
Bilangi
Richard
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002047:Buprenorphine / Q000008:administration & dosage*; D000069479:Buprenorphine, Naloxone Drug Combination; D004334:Drug Administration Schedule; 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*; D015813:Substance Abuse Detection; D013375:Substance Withdrawal Syndrome / Q000209:etiology; D013997:Time Factors; D014481:United States; D055815:Young Adult
D000069479:Buprenorphine, Naloxone Drug Combination; D009292:Narcotic Antagonists; D009270:Naloxone; D002047:Buprenorphine