Factors predicting the response to buprenorphine in substitutive therapy of heroin addicts - Results of a multicenter study of 73 patients

objective Buprenorphine has a partial morphine-agonist pharmacological prof ile. it is proposed as alternative to methadone in opiate drug addicts with greater safety of use and less cost in terms of public health. The aim of this study was to determine the clinical factors of response to this molecu le. Method The study was conducted in 73 patients treated for 3 months with ada ptable doses. Mean dose was 85 mg/d (range: 3 to 16 mg/d). Response to trea tment was defined as: still in the study at 3 months and absence of opiates in 75% of urinary samples over the past month. Results Forty-eight patients responded and 25 did not The determinating cli nical variables of response were: opiate drug addiction less than 10 years, high score on the Addiction Severity Index (ASI), absence of depression ac cording to the Minnesota Multiphasic Personality Inventory (MMPI) and low r ate of disinhibition on Zukerman's sensation seeking scale. Conversely, the dose of buprenorphine within the limits specified in the Marketing Authori sation did not intervene in the response. Conclusion In view of its partial agonist effect, administration of bupreno rphine must be reserved for patients addicted to opiates for less than 10 y ears, non-depressive and with low disinhibition on Zukerman's scale.