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

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 1360-0443 1359-6357
Keyword(s)	Ambulatory Buprenorphine Clonidine Detoxification 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
Persistent URL	http://hdl.handle.net/10536/DRO/DU:30008527

Document type:	Journal Article
Collection:	School of Health Sciences

Citation counts:	Cited 67 times in Scopus
Access Statistics:	317 Abstract Views, 1 File Downloads - Detailed Statistics
Created:	Mon, 13 Oct 2008, 15:34:36 EST

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