Treatment of Intravenous Buprenorphine Dependence A Randomized Open Clinical Trial

Background: Buprenorphine dependence is a new issue and to our knowledge no scientific papers have been published on treatment of buprenorphine dependency. The goal of this research was to characterize intravenous buprenorphine-dependent individuals with respect to socio-demographic and other background features, and to investigate the effect of methadone in the maintenance treatment of intravenous buprenorphine dependence in comparison with sublingual buprenorphine and also oral clonidine over a 12-week treatment period. Methods: Intravenous buprenorphine-dependent patients who met the DSM-IV criteria for opioid dependence were randomized to three groups. Results: The mean age was 29.4 years (range 19-46). The majority (86.1%) had a history of opium or heroin dependency before they were introduced to intravenous buprenorphine. The mean duration of buprenorphine dependence was 1.8 years and the mean ampoule per day was 4.6 ampoules (1 ampoule contains 0.3 mg of buprenorphine in 1 ml). Completion rates by groups were 83.3% for the methadone group, 58.3% for the buprenorphine group and 11.1% for the clonidine group (p < 0.0001). Retention in treatment was significantly better in the methadone group than in the buprenorphine group (p = 0.020) and the clonidine group (p < 0.0001). Retention in the buprenorphine group was significantly better than in the clonidine group (p < 0.0001). Conclusions: The results support the efficacy and safety of oral methadone and sublingual buprenorphine tablets for intravenous buprenorphine-dependent patients (German J Psychiatry 2003; 6: 23-29).