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Related Experiment Videos

Gradual dose taper following chronic buprenorphine.

A B Becker1, E C Strain, G E Bigelow

  • 1Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Md., USA.

The American Journal on Addictions
|July 11, 2001
PubMed
Summary

Most opioid-dependent patients relapsed during a 28-day buprenorphine taper, despite low withdrawal reports. Factors like craving and drug desire may drive relapse, suggesting longer tapers and varied treatments are needed.

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Area of Science:

  • Addiction Medicine
  • Pharmacology
  • Clinical Psychology

Background:

  • Opioid dependence is a chronic relapsing condition.
  • Buprenorphine is an effective medication for opioid use disorder.
  • Gradual dose tapering is a common strategy for treatment discontinuation.

Purpose of the Study:

  • To examine the time course of withdrawal and relapse during a 28-day outpatient buprenorphine dose taper.
  • To identify potential triggers for relapse in opioid-dependent individuals.

Main Methods:

  • Eight opioid-dependent volunteers underwent a 28-day gradual outpatient buprenorphine dose taper.
  • Treatment compliance was monitored via clinic attendance (96-100%).
  • Relapse was assessed using urinalysis and self-reported withdrawal symptoms.

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Main Results:

  • High compliance with the buprenorphine taper was observed.
  • 6 of 8 volunteers (75%) relapsed to opiate use by the end of the taper.
  • Reported withdrawal symptoms were generally low during the taper.

Conclusions:

  • A 28-day buprenorphine taper may be too rapid, leading to high relapse rates.
  • Relapse may be associated with craving, desire for positive effects, or low motivation.
  • Longer tapers and integrated treatment approaches may improve outcomes for opioid dependence.