Placebo-controlled Study of High Dose Buprenorphine in Opiate Dependents Waiting for Medication-assisted Rehabilitation in Oslo, Norway

• NCJ Number: 195256
• Journal: Addiction Volume: 97 Issue: 5 Dated: May 2002 Pages: 533-542
• Author(s): A. L. Krook; O. Brors; J. Dahlberg; K. Grouff; P. Magnus; E. Roysamb; H. Waal
• Date Published: 2002
• Length: 10 pages
• Publication Format: Article
• Publication Type: Program/Project Evaluation
• Language: English
• Country: United Kingdom

Annotation

This Norwegian study assessed whether buprenorphine, even without additional control and psychosocial treatment and support, alleviated the problems experienced by opiate dependents who were waiting for medication-assisted rehabilitation (MAR).

Abstract

Both methadone and high-dose buprenorphine (Subutex) are available for treatment of opioid addiction in Norway. Methadone is a full u-receptor agonist; whereas, buprenorphine is a partial agonist. One effect derived from buprenorphine is diminished respiratory depression and therefore reduced risk of death due to overdose. A 12-week randomized double-blind study of buprenorphine versus placebo without additional rehabilitation or support was performed. Participants were 106 patients (70 males and 36 females) waiting for MAR in Oslo. The average age of the participants was 38 years, with an average history of heroin use of 20 years. Fifty-five patients were assigned to buprenorphine and 51 to a placebo. Subutex or placebo sublingual tablets were administered under supervision in a daily dose of 16 mg, with the exception of a double dose on Saturday and no dose on Sunday. The variables measured were retention, compliance, self-reported drug abuse, well-being, and mental health. The study found that the average number of days of participation was significantly higher in the Subutex group (42 compared to 14 for the placebo group). The retention of patients after 12 weeks involved 16 patients in the Subutex group and 1 patient in the placebo group. The Subutex group had a larger decrease in reported opioid use and in reported use of other drugs, tablets, and alcohol abuse. The group also showed a stronger increase in well-being and life satisfaction. None of the participants died. The patients waiting for MAR thus benefited significantly from the Subutex as an interim therapy as measured by retention, self-reported use of drugs, and well-being; however, the patients had difficulty remaining in treatment over time without psychosocial support. It is feasible to offer this treatment to hardcore addicts on a waiting list for a limited time period. 3 tables, 2 figures, and 32 references