Buprenorphine is an opiate agonist/antagonist that has been proposed as a short-term maintenance and detoxification pharmacotherapy for opiate dependence. Buprenorphine has been studied showing good acceptance and no serious side-effects. Recently, it has been suggested that buprenorphine may also have utility in decreasing cocaine usage. This study will compare the effectiveness of buprenorphine in suppressing the use of illicit opiates and cocaine. Up to 200 dually-dependent (opiate/cocaine) individuals will be enrolled into the study; 50 each assigned to one of four treatment groups contingent on stratification restrictions. All subjects will receive routine non-medical treatment services in accord with their needs and functioning. Subjects will be offered individual counseling once weekly based on a relapse-prevention model. Primary dependent variables will be urine samples positive for opiates and cocaine. Secondary dependent variables will be: 1) retention time in the study (91 days), 2) number of missed clinic visits, 3) subject-reported side effects, depression and urge and need for opiates and cocaine (as measures of craving), 4) subject-reported opiate and cocaine withdrawal effects, and 5) results from blood chemistries and urinalysis. Subject enrollment recently began in this study. Five subjects have started and are presently enrolled in this treatment study.
