Buprenorphine tapering schedule and illicit opioid use.
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ABSTRACT:
SUBMITTER: Ling W
PROVIDER: S-EPMC3150159 | biostudies-literature | 2009 Feb
REPOSITORIES: biostudies-literature
Publications
Buprenorphine tapering schedule and illicit opioid use.
Ling Walter W 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
Addiction (Abingdon, England) 20090201 2
<h4>Aims</h4>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.<h4>Design</h4>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 a ...[more]
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Project description:AimsDetermine the extent to which buprenorphine injectors continue treatment with buprenorphine-naloxone or methadone, and the impact of these treatments on substance use and HIV risk in the Republic of Georgia.MethodsRandomized controlled 12-week trial of daily-observed methadone or buprenorphine-naloxone followed by a dose taper, referral to ongoing treatment, and follow-up at week 20 at the Uranti Clinic in Tbilisi, Republic of Georgia. Eighty consenting treatment-seeking individuals (40/group) aged 25 and above who met ICD-10 criteria for opioid dependence with physiologic features and reported injecting buprenorphine 10 or more times in the past 30 days. Opioid use according to urine tests and self-reports, treatment retention, and HIV risk behavior as determined by the Risk Assessment Battery.ResultsMean age of participants was 33.7 (SD5.7), 4 were female, mean history of opioid injection use was 5.8 years (SD4.6), none were HIV+ at intake or at the 12-week assessment and 73.4% were HCV+. Sixty-eight participants (85%) completed the 12-week medication phase (33 from methadone and 35 from buprenorphine/naloxone group); 37 (46%) were in treatment at the 20-week follow-up (21 from methadone and 16 from the buprenorphine/naloxone group). In both study arms, treatment resulted in a marked reduction in unprescribed buprenorphine, other opioid use, and HIV injecting risk behavior with no clinically significant differences between the two treatment arms.ConclusionsDaily observed methadone or buprenorphine-naloxone are effective treatments for non-medical buprenorphine and other opioid use in the Republic of Georgia and likely to be useful for preventing HIV infection.
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