Comparative trial to study the effectiveness of clonidine hydrochloride and buprenorphine-naloxone in opioid withdrawal - a hospital based study.
OBJECTIVE
Prevalence of opioid addiction has alarmingly increased over the recent years. In South Asian region alone there are more than 10 million opioid abusers amounting to 2% of world population. Detoxification remains to be the first step for the successful treatment of opioid addiction. The present study was carried out to compare the relative efficacy and safety of buprenorphine -naloxone and clonidine hydrochloride in the detoxification of opioid-dependents.


METHODS
Present trial was conducted at De- addiction centre of Institute of Mental and Neurosciences (IMNS), GMC Srinagar. Fifty four (54) treatment seeking subjects, 15-50 years of age, fulfilling DSM-1V TR (American Psychiatric association`s Mental Disorders-1V text revision) criteria for opioid dependence were included and randomized into two groups. The groups received either clonidine hydrochloride (Group A) or buprenorphine- naloxone (Bup-Nax) (Group B) for the duration of 10 days. The efficacy of the two drugs in controlling the opioid withdrawal was evaluated by Clinical Opioid Withdrawal Scale (COWS) and their effect on the desire for the abused substance was measured by Visual Analogue Scale (VAS). The safety of the two drugs was measured by taking the side effect profile of the two compared drugs into consideration.


RESULTS
There was significant difference of COWS-score between the two groups which was evident from day 3 (14.85 ± 3.43 vs. 11.67 ± 2.40, p<0.005) and continued till day 6 (2.56 ± 1.40 vs. 0.30 ± 0.61, p<0.005), for Group A and group B respectively. The effect of two drugs in controlling the craving for the abused substance also showed significant difference from day 2 (66.30 ± 10.80 vs. 47.40 ± 12.90, p<0.005) till day 5 (7.78 ± 6.41 vs. 1.85 ± 6.22, p<0.005), for Group A and Group B respectively.


CONCLUSIONS
Administration of buprenorphine-naloxone was more efficient in reducing the signs and symptoms of opioid withdrawal and in controlling the craving for the abused substance during the first few days of detoxification.
Demonstrator, Department of Pharmacology, Government Medical Collage Srinagar, Jammu and Kashmir, India .
Syed Sajad
SS
Hussain
Associate Professor and Head, Department of Pharmacology, GMC Srinagar, India .
Samina
S
Farhat
Lecturer, Department of Psychiatry, Institute of Mental Health and Neurosciences, GMC Srinagar, India .
Yasir Hassan
YH
Rather
Professor & Head, Department of Pharmacology, Luxmi Bai Institute of Dental Sciences and Hospital , Sirhind Road Patiala Punjab, India .
Zaffar
Z
Abbas
Buprenorphine-naloxone; Clinical opioid withdrawal scale; Clonidine; Opioid addiction; Visual analogue scale