Background: Buprenorphine is a promising alternative to methadone or levo-a
cetyl alpha methadol for opioid agonist maintenance treatment, and thrice-w
eekly dosing would facilitate its use for this purpose.
Methods: After a 3-day induction, opioid-dependent patients (n = 92) were r
andomly assigned to daily clinic attendance and 12-weeks maintenance treatm
ent with sub-lingual buprenorphine administered double blind either daily (
n = 45; 16 mg/70 kg) or thrice weekly (n = 47; 34 mg/70 kg on Fridays and S
undays and 44 mg/70 kg on Tuesdays). Outcome measures include retention, re
sults of 3X/week urine toxicology tests, and weekly self-reported illicit d
rug use.
Results: There were no significant differences at baseline in important soc
ial, demographic and drug-use features. Retention was 71% in the daily and
77% in the 3X/week conditions. The proportion of opioid-positive urine test
s decreased significantly from baseline in both groups and averaged 57% (da
ily) and 58% in 3X/week, There were no significant differences between grou
ps in self-reported number of bags of heroin wed for any day of the week, i
ncluding Thursdays (48-72 hours following the last buprenarphine dose for s
ubjects in the 3X/week condition), or in medication compliance (92%, 91%) a
nd counseling attendance (82%, 82%),
Conclusions: At art equivalent weekly dose of 112 mg/70 kg, thrice-weekly a
nd daily sublingual buprenorphine appear comparable in efficacy with regard
to retention and reductions in illicit opioid and other drug Else. These f
indings support the potential for utilizing thrice-weekly buprenorphine dos
ing in novel settings. (C) 2000 Society of Biological Psychiatry.