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A randomized controlled trial of buprenorphine in the management of short-term ambulatory heroin withdrawal

Lintzeris, Nicholas, Bell, James, Bammer, Gabriele, Jolley, Damien J. and Rushworth, Louise 2002, A randomized controlled trial of buprenorphine in the management of short-term ambulatory heroin withdrawal, Addiction, vol. 97, no. 11, pp. 1395-1404.

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Title A randomized controlled trial of buprenorphine in the management of short-term ambulatory heroin withdrawal
Author(s) Lintzeris, Nicholas
Bell, James
Bammer, Gabriele
Jolley, Damien J.
Rushworth, Louise
Journal name Addiction
Volume number 97
Issue number 11
Start page 1395
End page 1404
Publisher Wiley-Blackwell Publishing Ltd.
Place of publication Oxford, England
Publication date 2002-11
ISSN 0965-2140
Keyword(s) Ambulatory
Heroin withdrawal
Randomized controlled trial
Summary Aim: To determine whether buprenorphine is more effective than clondine and other symptomatic medications in managing ambulatory heroin withdrawal.
Design: Open label. prospective randomized controlled trial examining
withdrawal and 4-week postwithdrawal outcomes on intention-to-treat.
Setting: Two specialist, out-patient drug treatment centres in inner city
Melbourne and Sydney, Australia.
Participants: One hundred and fourteen dependent heroin users were recruited. Participants were 18 yea rs or over. and with no significant other drug dependence, medical or psychiatric conditions or recent methadone treatment. One hundred and one (89%) participants completed a day 8 research interview examining withdrawal outcomes, and 92 (81%) completed day 35 research interview examining postwithdrawal outcomes.
Interventions: Participants randomized to control (n = 56) (up to 8 days or
clonidine and other symptomatic medications) or experimental (n = 58) (up to 5 days of buprenorphine) withdrawal groups. Following the 8-day withdrawal episode, participants could self-select from range of postwithdrawal options (naltrexone, substitution maintenance or counselling).
Measurements: Retention in withdrawal: heroin use during withdrawl: and
retention in drug treatment 4 weeks after withdrawal.
Secondary outcomes: Withdrawal severity: adverse events, and heroin use in the postwithdrawal period.
Findings: The experimental group had better treatment retention at day 8 (86% versus 57%, P = 0.001, 95% CI for numbers needed to treat (NNT) = 3-8) and day 35 (62% versus 39%, P = 0.02, 95% CI for NNT = 4-18): used heroin on fewer days during the withdralwal programlme (2.6 ± 2.5 versus 4.5 ± 2. 3.
P < 0.001. 95% CI = 1- 2.5 days) and in the postwithdrawal period (9.0±8.2
versus 14.6± 10. P<O.Ol. 95% CI = I .8- 9.4): and reported less withdrawal
severity. No severe adverse events reported.
Conclusions: Buprenorphine is effective for short-term ambulatory heroin
withdrawaI, with greater retention, less heroin use and less withdrawal discomfort during withdrawal: and increased postwithdrawal treatment retention than symptomatic medications.

Language eng
Field of Research 111799 Public Health and Health Services not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2002, Society for the Study of Addiction to Alcohol and Other Drugs
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Document type: Journal Article
Collection: School of Health Sciences
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