Related Experiment Video
Updated: Jun 26, 2026
08:05
A Procedure to Study Stress-Induced Relapse of Heroin Seeking after Punishment-Imposed Abstinence
Published on: March 23, 2022
Buprenorphine tapering schedule and illicit opioid use
Walter Ling1, Maureen Hillhouse, Catherine Domier
1University of California, Los Angeles, CA 90025, USA.
Addiction (Abingdon, England)
|January 20, 2009
Summary
A shorter 7-day buprenorphine taper resulted in more opioid-free urine tests immediately after treatment compared to a 28-day taper. Prolonging the buprenorphine taper duration showed no long-term advantage for opioid dependence treatment outcomes.
Area of Science:
- Addiction Medicine
- Pharmacotherapy Research
- Clinical Trials Network (CTN) Studies
Background:
- Opioid dependence is a significant public health issue requiring effective pharmacotherapies.
- Buprenorphine is a widely used medication for opioid dependence treatment.
- Tapering strategies for buprenorphine vary, with unclear optimal durations.
Purpose of the Study:
- To compare the efficacy of short (7-day) versus long (28-day) buprenorphine taper schedules.
- To assess participant outcomes using opioid-free urine tests post-taper.
- To inform clinical practice regarding buprenorphine discontinuation.
Main Methods:
- Multi-site, outpatient study (2003-2005) involving 516 participants.
- Two groups: 7-day taper and 28-day taper after buprenorphine stabilization.
- Urine drug screens collected at taper end and 1- and 3-month follow-ups.
Main Results:
- At taper end, 44% of the 7-day group (n=255) had opioid-free urine vs. 30% of the 28-day group (n=261; P=0.0007).
- No significant differences in opioid-free urine tests were observed at 1-month and 3-month follow-ups between groups.
- Short tapers demonstrated higher immediate abstinence rates.
Conclusions:
- A short (7-day) buprenorphine taper is as effective as a longer (28-day) taper for maintaining opioid abstinence.
- Prolonging the buprenorphine taper duration offers no discernible advantage for treatment outcomes.
- Findings support shorter taper durations for buprenorphine discontinuation.
Related Concept Videos
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
01:20Opioid Analgesics: Morphine and Other Natural Cogeners
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
01:25Analgesia and Pain Management
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
01:28IV Infusion to Oral Dosing: Conversion Methods
The development of extended-release formulations has facilitated the transition from intravenous to oral medication, offering a more convenient and patient-friendly approach to drug administration. This transition, however, requires careful management to ensure that therapeutic drug levels are maintained, preserving efficacy and avoiding adverse effects. Understanding pharmacokinetic principles and dosage calculations is critical during this process.Pharmacokinetics of the...
01:17Drug Dependence
Medications are typically administered to achieve therapeutic effects. Some drugs can modify an individual's mood and perception, frequently resulting in various enjoyable experiences. However, this can result in drug dependency, a condition marked by continuous drug use despite potential negative consequences. Drug dependency primarily falls into two categories: psychological and physical dependence. Psychological dependence occurs when the pleasurable feelings induced by the drug...
01:14CNS Depressants: Barbiturates and Benzodiazepines
CNS depressants include drugs from the category of barbiturates and benzodiazepines. They are valuable medications for managing anxiety disorders and insomnia. Barbiturates, once used to induce and maintain sleep, have been replaced mainly by benzodiazepines due to barbiturate's toxicity, tolerance, and overdose risks. They interact with GABAA receptors, leading to sedation at low doses and potentially coma and death at higher doses. Phenobarbital, a long-acting barbiturate, possesses...