American Journal of Drug and Alcohol Abuse 2011;37(5):453-459. [doi: 10.3109/00952990.2011.596974]
Maureen Hillhouse, PhD, Catherine P. Canamar, PhD, Geetha Doraimani, MS, Christie Thomas, MPH, Albert Hasson, MSW, Walter Ling, MD (all from Integrated Substance Abuse Programs, UCLA, PR Node).
Clinical parameters for determining buprenorphine dose have not been adequately examined in treatment outcome research. This study is a secondary analysis of data collected from National Drug Abuse Treatment Clinical Trials Network (CTN) protocol CTN-0003, a recently completed comparison of buprenorphine taper schedules designed to assess whether participant baseline characteristics are associated with buprenorphine dose. For this ancillary investigation, 516 participants were categorized by dose provided in the final dosing week after 3 weeks of flexible dosing (9.3% received a final week dose of 8 mg buprenorphine, 27.3% received 16 mg, and 63.4% received 24 mg). Findings show that final week dose groups differed in baseline demographic and drug use characteristics including education, heroin use, route of drug administration, withdrawal symptoms, and craving. These groups also differed in opioid use during the four dosing weeks, with the lowest use in the 8 mg group and highest use in the 24 mg group (p < .0001). A significant association was also found between final week dose group and withdrawal and craving. Participants with greater withdrawal symptoms and craving scores had larger final week doses.
Conclusions: Final week dose groups in this investigation differed in demographic and drug use characteristics, and the group receiving the largest final week dose had the highest rate of continued opioid use. These findings may contribute to the development of clinical guidelines regarding buprenorphine dose in the treatment of opioid dependence; however, further investigations that include random assignment to dose by baseline characteristics are needed. Methods for determining optimal buprenorphine dose will be extremely helpful in clinical settings in which physicians currently have no formal tools for determining appropriate dosages. (Article (Peer-Reviewed), PDF, English, 2011)
Keywords: Buprenorphine/Naloxone | Community health services | Craving | Heroin | Pharmacological therapy | Opioid dependence | Suboxone | Taper schedules | Withdrawal syndrome | American Journal of Drug and Alcohol Abuse (journal)
Document No: 732, PMID: 21854290, PMCID: PMC3272773.
Submitted by CTN Dissemination Librarians, 8/23/2011.