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Buprenorphine Tapering Schedule and Illicit Opioid Use.

Addiction 2009;104:256-265 [doi: 10.1111/j.1360-0443.2008.02455.x]

Walter Ling, MD (Integrated Substance Abuse Programs, UCLA, PR Node), Maureen Hillhouse, PhD (Integrated Substance Abuse Programs, UCLA, PR Node), Catherine P. Domier, MA (Integrated Substance Abuse Programs, UCLA, PR Node), Geetha Doraimani (Integrated Substance Abuse Programs, UCLA, PR Node), Jeremy Hunter (Integrated Substance Abuse Programs, UCLA, PR Node), Christie Thomas, MPH (Friends Research Institute, Inc., PR Node), Jessica Jenkins (Integrated Substance Abuse Programs, UCLA, PR Node), Albert Hasson, MSW (Integrated Substance Abuse Programs, UCLA, PR Node), Jeffrey J. Annon, MA (Integrated Substance Abuse Programs, UCLA, PR Node), Andrew J. Saxon, MD (Veterans Affairs Puget Sound Health Care System, PN Node), Jeffrey A. Selzer, MD (North Shore Long Island Jewish Health System, LI Node), Joshua Boverman, MD (Oregon Health and Science University, OR/HI Node), Richard Bilangi, MD (Connecticut Counseling Centers, Inc., NE Node).

This is the Primary Outcomes Article for CTN-0003. The purpose of CTN-0003 was to compare 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. This multi-site study sponsored by NIDA's National Drug Abuse Treatment Clinical Trials Network was conducted from 2003-2005 to compare two taper conditions (7 days and 28 days). Data were collected at weekly clinic visits through the end of the taper periods, and at 1-month and 3-month post-taper follow-up visits. The intervention involved non-blinded dosing with Suboxone during the 1-month stabilization phase, including three 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. Measurements included 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. At the end of the taper, 44% of the 7-day taper group (n=255) provided opioid-free urine speciments compared to 30% of the 28-day taper group (N=261; p=0.0007). There were no differences at the 1- and 3-month follow-up (7 day = 18% and 12%; 28 day = 18% and 13%, for 1 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. (Article, Peer-Reviewed, PDF, English, 2009)

Keywords: Buprenorphine/Naloxone | Community health services | CTN primary outcomes | Opioid dependence | Pharmacological therapy | Suboxone | Taper schedules | Addiction (journal)

Document No: 323, PMID: 19149822, PMCID: PMC3150159

Submitted by Jack Blaine, MD, Senior Medical Consultant for the CTN, and Quandra Scudder, NIDA.

Annon, Jeffrey J. search mail
Bilangi, Richard search mail
Boverman, Joshua search
Domier, Catherine P. search mail
Doraimani, Geetha search
Hasson, Albert search mail
Hillhouse, Maureen search mail
Hunter, Jeremy search
Jenkins, Jessica search mail
Ling, Walter search mail
Saxon, Andrew J. search mail
Selzer, Jeffrey A. search mail
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