CONTROLLED OPIOID WITHDRAWAL EVALUATION DURING 72 H DOSE OMISSION IN BUPRENORPHINE-MAINTAINED PATIENTS

Buprenorphine's clinical utility as an opioid dependence pharmacothera py may be enhanced with less-than-daily dosing. This study assessed op ioid withdrawal after an acute 72 h dose omission in buprenorphine-mai ntained patients (8 mg/day s.l.). Eight outpatients required to remain free of opioids, cocaine and benzodiazepines completed four double-bl ind, double-dummy, Latin-square ordered conditions. Test conditions of 8 or 16 mg s.l. buprenorphine were followed by 2 days of placebo dosi ng. Control conditions were buprenorphine maintenance (8 mg/day), to p rovide a reference for evaluation of placebo test days and naloxone ad ministration (10 mg/70 kg i.m.) during 8 mg buprenorphine maintenance to assess withdrawal measure sensitivity. Subjective measures and pupi l diameter were significantly influenced only by naloxone. The lack of subjective symptoms and physiological signs of opioid withdrawal duri ng 72 h of acute dose omission supports the feasibility of less-than-d aily dosing at buprenorphine doses of 8 mg/day in patients who have de monstrated an ability to remain drug-free for an extended period. (C) 1997 Elsevier Science Ireland Ltd.