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Transferring methadone-maintained outpatients to the buprenorphine sublingual tablet: a preliminary study
Mark K Greenwald1, Kory J Schuh, Susan M Stine
1Substance Abuse Research Division, Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48207, USA. mgreen@med.wayne.edu
Abstract:
There is no accepted algorithm to transfer opioid-dependent patients from methadone (METH) to its new alternative, buprenorphine (BUP). Five outpatients transferred (double blind, double dummy) from METH 60 mg/day (with one day at 45 mg) to BUP 8 mg s.l. tablet. Relative to METH maintenance, BUP decreased opioid agonist symptoms (transfer day 1) and increased withdrawal symptoms (days 1 and 2) and blood pressure (day 2). Self-reported heroin use did not increase from METH maintenance levels. It may be feasible to transfer outpatients on METH 60 mg/day to BUP 8 mg/day s.l. tablet, although this pilot protocol needs refinements to improve tolerability and clinical efficacy.