A Comparison of the Efficacy of Buprenorphine and Clonidine in Detoxification of Heroin-Dependents and the Following Maintenance Treatment

Abstract Background: This study compared the success rates of buprenorphine and clonidine in detoxification of heroin-dependents and evaluated the recurrence of drug abuse in patients taking naltrexone in a 6 month follow up. Methods: A double-blind study was carried out in Kerman’s psychiatric hospital on heroin-dependents seeking detoxification during the years 2007-2009.These patients were randomized into 2 groups receiving clonidine and buprenorphine. The success rate of detoxification was evaluated at the end of the trial and each patient was discharged with a daily consumption of 25 mg naltrexone. They were monitored for 6 months with respect to naltrexone consumption and withdrawal from drug abuse. Findings: Overall 49 patients participated in the study. The success rate of detoxification with naltrexone was confirmed in all subjects. In the group receiving clonidine, 2 subjects (9.5%) had a clinical opiate withdrawal scale (COWS) above 12 in day 5 (P = 0.186) and none of the subjects in the group taking buprenorphine had a COWS above 12 in day 5. The signs and symptoms of withdrawal and the desire for substance abuse was declined significantly in both groups over time; 19% of subjects detoxified with clonidine and 39% detoxified with buprenorphine continued taking naltrexone for one month and 52% detoxified with clonidine and 53.5% detoxified with buprenorphine entered the maintenance treatment. The average days remaining in treatment and being free of recurrence of drug abuse was not significantly different between the two groups in a 6 month follow up. Conclusion: Administration of buprenorphine within a few days was more efficient in reducing the signs and symptoms of withdrawal when compared to clonidine. However, recurrence of drug abuse was not significantly different between the two groups. Keyword: Clonidine, Buprenorphine, Naltrexone, Heroin withdrawal, Recurrence