The proposed study is an evaluation of two new methods for increasing the success of the agonist (methadone) to antagonist (naltrexone) transition. Methadone maintained patients have had difficulty starting naltrexone, possibly because of mild withdrawal symptoms during the initial doses of naltrexone. To decrease these symptoms we will use buprenorphine and a combination of clonidine with naltrexone in three studies: 1. An open study is designed to establish the parameters for buprenorphine's use. Patients will be abruptly switched from methadone to buprenorphine and then started on gradually increasing doses of naltrexone. Variations such as tapering the buprenorphine dose or starting with different doses of naltrexone will be tried to optimize symptom reduction. 2. The efficacy of buprenorphine will be compared to methadone tapering for induction onto naltrexone of outpatient methadone maintained patients using a double blind, random assignment trial. 3. We will try to shorten the time for making a transition from methadone maintenance to naltrexone by using both clonidine and buprenorphine. Two sequential randomizations will occur in this double blind trial: 1) at day 0 to clonidine or buprenorphine, 2) at day 17 to naltrexone + clonidine or naltrexone + placebo.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Scientist Development Award - Research (K02)
Project #
5K02DA000112-03
Application #
3069464
Study Section
Drug Abuse Clinical and Behavioral Research Review Committee (DACB)
Project Start
1987-03-01
Project End
1992-02-29
Budget Start
1989-03-01
Budget End
1990-02-28
Support Year
3
Fiscal Year
1989
Total Cost
Indirect Cost
Name
Yale University
Department
Type
Schools of Medicine
DUNS #
082359691
City
New Haven
State
CT
Country
United States
Zip Code
06520
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