This component proposes to continue our work on the development of buprenorphine as a pharmacotherapy for opiate addiction. Specifically, we aim to improve the clinical utility of buprenorphine via information gained in three related protocols. First, the range of daily buprenorphine doses on which patients are able to stabilize will be examined in a sample of 300 subjects. Approximately one-half of these subjects who stabilize on a daily buprenorphine dose will be randomly assigned to one of three dose interval groups to learn if the daily buprenorphine dose is sufficient to prevent withdrawal for 48 hours or if a higher dose is necessary. The first group will continue to receive their stabilization dose of buprenorphine daily, the second group will receive that dose on a three-times-a-week basis, and the third will receive a higher dose on the same schedule. Groups will be compared with respect to clinical performance as measured by the Treatment Effectiveness Scale, a composite outcome measure which reflects urine toxicology and retention in treatment. Other outcome measures examined will include self-reported opiate use, craving, and a global rating. Finally, a related project will evaluate two buprenorphine discontinuation protocols in 60 subjects voluntarily requesting detoxification, featuring a long (6 week) and short (3 weeks) taper. The relative success of the two schedules will be reflected in the number of subjects who achieve a zero dose without undue withdrawal or need for adjunctive clonidine treatment.
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| Ling, Walter; Wesson, Donald R (2003) Clinical efficacy of buprenorphine: comparisons to methadone and placebo. Drug Alcohol Depend 70:S49-57 |
| Lopatko, Olga V; White, Jason M; Huber, Alice et al. (2003) Opioid effects and opioid withdrawal during a 24 h dosing interval in patients maintained on buprenorphine. Drug Alcohol Depend 69:317-22 |
| Ling, Walter; Rawson, Richard A; Compton, Margaret (2003) Clinical treatment of opioid addiction and dependence. Methods Mol Med 84:285-95 |
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| Kirkish, P; Sreenivasan, S; Welsh, R et al. (2000) The future of criminal violence: juveniles tried as adults. J Am Acad Psychiatry Law 28:38-46 |
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