BUPRENORPHINE AND NALOXONE INTERACTIONS IN METHADONE-MAINTENANCE PATIENTS

Buprenorphine is undergoing clinical trials for the treatment of opiat e addiction, Although the abuse liability of sublingual buprenorphine is low, reports of intravenous abuse have appeared, This study describ es the physiologic and subjective effects of intravenously administere d buprenorphine and naloxone given alone and in combination to methado ne-maintained patients (40-60 mg/day). On four separate occasions at l east 1 day apart, 6 subjects were administered either 0.2 mg buprenorp hine, 0.1 mg naloxone, 0.2 mg buprenorphine and 0.1 mg naloxone in com bination, or placebo, One male subject quit the experiment after three sessions because of excessive opiate withdrawal. Buprenorphine produc ed no significant physiologic or subjective effects. Naloxone produced marked opiate withdrawal symptoms, Buprenorphine in combination with naloxone produced characteristic physiologic and subjective opiate ant agonist-like symptoms and signs, The parenteral abuse potential of the buprenorphine and naloxone combination is discussed. (C) 1997 Society of Biological Psychiatry.