Buprenorphine maintenance treatment of opiate dependence: a multicenter, randomized clinical trial

Abstract

The findings support the safety and efficacy of buprenorphine and suggest that an adequate dose of buprenorphine will be a useful addition to pharmacotherapy.

Maintenance treatment with buprenorphine and naltrexone for heroin dependence in Malaysia: a randomised, double-blind, placebo-controlled trial

“…The findings in this study of significant superiority of buprenorphine compared to placebo on all of our primary drug use outcome measures and retention are consistent with the results of other placebo-controlled studies of buprenorphine in the U.S., 18,20,23 Norway 22 and Sweden. 21 The findings of significant superiority of buprenorphine compared to naltrexone for retention and time to resuming heroin use are unique.…”

“…The lack of direct comparisons may contribute to policy makers' assumption that there are no advantages to introducing opioid agonist maintenance treatment (and continued prohibition of this treatment) if naltrexone maintenance treatment is available. Additionally, there are relatively few placebo-controlled clinical trials of either buprenorphine 18,[20][21][22][23] or naltrexone maintenance. 8,[11][12][13]24 Consequently, this double-blind, double-dummy, placebo-controlled randomized clinical trial compared the efficacy for maintaining heroin abstinence, preventing relapse, and reducing HIV risk behaviors following detoxification of 24 weeks of drug counseling alone (combined with placebo) or combined with maintenance with naltrexone or buprenorphine.…”

Buprenorphine: A Unique Drug with Complex Pharmacology

“…This opioid analgesic, which was the focus of many clinical trials for the treatment of opioid dependency [32,47,49,50,59], even in opiate addicts with a history of cocaine co-abuse [72,85,86], has recently been approved for the treatment of opioid dependency [30]. However, the mechanisms of action of buprenorphine are not fully understood.…”

Time-Course of Buprenorphine Dose Increase in a Maintenance Program for Heroin Addicts: Retention in Treatment and Clinical Meaning

“…In fact, early attrition in buprenorphine programs seems to be related to withdrawal buffering, and does not vary according to dosage, due to limited agonist potency. On the other hand, for those who stay in treatment at anti-withdrawal dosages, higher dosages grant with better outcomes in fixed dose comparison studies [12]. However, it is not sharply clear whether the gap of effectiveness is mainly related to a higher level of agonism or the opioid blockade: In fact, some patients do respond to 2-4-6 mg regimens by a significant rate [2,19].…”

“…Buprenorphine is a major therapeutic option in the treatment of opiate addiction [1][2][3][4][5][6][7][8][9][10][11][12][13]. Peculiarly, increasing dosages do not grant higher and higher levels of agonism, but a plateau is soon reached due to it's the high affinity to the μ-receptor (ceiling effect) [14][15][16].…”