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Related Experiment Videos

Buprenorphine: how to use it right.

Rolley E Johnson1, Eric C Strain, Leslie Amass

  • 1Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, USA. ed.johnson@reckittbenckiser.com

Drug and Alcohol Dependence
|May 10, 2003
PubMed
Summary

Buprenorphine, including its combination with naloxone, effectively treats opioid dependence with a favorable safety profile and flexible dosing. This medication offers a viable option for office-based treatment, reducing abuse potential and improving patient access.

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Area of Science:

  • Pharmacology and Addiction Medicine

Background:

  • Buprenorphine's unique mu-opioid receptor pharmacology (high affinity, low intrinsic activity, slow dissociation) confers a good safety profile, low physical dependence, and flexible dosing.
  • Early research utilized buprenorphine sublingual solution for opioid dependence treatment.
  • Recent advancements include a buprenorphine/naloxone combination tablet (4:1 ratio) designed to mitigate diversion and abuse.

Purpose of the Study:

  • To evaluate the effectiveness of buprenorphine formulations in treating opioid dependence.
  • To assess the impact of the buprenorphine/naloxone combination tablet on abuse potential.
  • To review dosing schedules and withdrawal protocols for buprenorphine treatment.

Main Methods:

  • Controlled studies comparing buprenorphine solution, mono-tablet, and buprenorphine/naloxone combination tablet.

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  • Analysis of clinical effectiveness, safety profiles, and abuse potential.
  • Review of established induction, maintenance, and withdrawal dose schedules.

    • Main Results:

    • All studied buprenorphine formulations demonstrated effectiveness in treating opioid dependence.
    • The buprenorphine/naloxone combination tablet showed a reduction, though not elimination, in abuse potential.
    • Clinical effects of buprenorphine and buprenorphine/naloxone are comparable, with typical daily doses of 4:1-24:6 mg.
    • Gradual dose reduction is recommended for buprenorphine withdrawal.

    Conclusions:

    • Buprenorphine, in both solution and tablet forms (including the buprenorphine/naloxone combination), is a proven treatment for opioid dependence.
    • The buprenorphine/naloxone combination offers enhanced safety by reducing diversion risk.
    • Both formulations are FDA-approved Schedule III narcotics, facilitating office-based treatment and expanding patient access to care.