Detoxification of opiate addicts with multiple drug abuse: effects of buprenorphine on affect, anxiety, and withdrawal symptoms

We used an open-labeled,21-day inpatient detoxification treatment to compar e the short-term effects of a 10-day buprenorphine plus 19-day carbamazepin e regimen (n=15) to a 14-day oxazepam plus 19-day carbamazepine regimen (n= 12) during rapid detoxification from opioids and other abused drugs. Somati c and psychopathological changes were assessed using the following rating s cales: ASI, HAMD, SCL-90-R, and SOWS. Eighteen of 27 patients (67%) complet ed the study. Four dropouts (27%) were treated with buprenorphine/carbamaze pine (BPN/CBZ) and the other five dropouts (42%) were treated with oxazepam /carbamazepine (OXA/CBZ). Repeated measures analysis of variance showed tha t SOWS scores were significantly less pronounced with BPN-CBZ than with OXA /CBZ. On the first day of admission, no significant difference in HAMD scor es was detected (BPN/CBZ11.6, BPN/CBZ 1.0). On day 14, HAMD was significant ly less pronounced in BPN/CBZ (3.0) than in OXA/CBZ (6.1). BPN/CBZ showed a significant improvement in the ASI score on days 7 and 14 compared with OX A/CBZ. Three of nine items of the SCL-90-R showed a trend toward less prono unced outcome in BPN-CBZ. No severe side effects occurred during treatment in either group. The buprenorphine/carbamazepine regimen provided significa ntly more effective relief from affect disturbances and withdrawal syndrome s than the oxazepam/carbamazepine regimen. The pharmacological basis of the se effects of buprenorphine (kappa-antagonism activity, mu-agonism activity ) are discussed.