Participant characteristics and buprenorphine dose

Am J Drug Alcohol Abuse. 2011 Sep;37(5):453-9. doi: 10.3109/00952990.2011.596974.

Abstract

Background: Clinical parameters for determining buprenorphine dose have not been adequately examined in treatment outcome research.

Objectives: This study is a secondary analysis of data collected in a recently completed comparison of buprenorphine taper schedules conducted as part of the National Institute on Drug Abuse's Clinical Trials Network to assess whether participant baseline characteristics are associated with buprenorphine dose.

Methods: After 3 weeks of flexible dosing, 516 participants were categorized by dose provided in the final dosing week (9.3% received a final week dose of 8 mg buprenorphine, 27.3% received 16 mg, and 63.4% received 24 mg).

Results: Findings show that final week dose groups differed in baseline demographic and drug use characteristics including education, heroin use, route of drug administration, withdrawal symptoms, and craving. These groups also differed in opioid use during the four dosing weeks, with the lowest use in the 8 mg group and highest use in the 24 mg group (p < .0001). Additional analyses address withdrawal symptoms and craving.

Conclusions and scientific significance: Final week dose groups differed in demographic and drug use characteristics, and the group receiving the largest final week dose had the highest rate of continued opioid use. These findings may contribute to the development of clinical guidelines regarding buprenorphine dose in the treatment of opioid dependence; however, further investigations that include random assignment to dose by baseline characteristics are needed.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Analgesics, Opioid / administration & dosage*
  • Analgesics, Opioid / therapeutic use
  • Buprenorphine / administration & dosage*
  • Buprenorphine / therapeutic use
  • Buprenorphine, Naloxone Drug Combination
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Heroin Dependence / rehabilitation
  • Humans
  • Male
  • Middle Aged
  • Naloxone / administration & dosage
  • Naloxone / therapeutic use
  • Narcotic Antagonists / administration & dosage
  • Narcotic Antagonists / therapeutic use
  • National Institute on Drug Abuse (U.S.)
  • Opiate Substitution Treatment / methods*
  • Opioid-Related Disorders / rehabilitation*
  • United States

Substances

  • Analgesics, Opioid
  • Buprenorphine, Naloxone Drug Combination
  • Narcotic Antagonists
  • Naloxone
  • Buprenorphine