Thrice-weekly versus daily buprenorphine maintenance

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.