Related Experiment Videos
A protocol to switch high-dose, methadone-maintained subjects to buprenorphine
F R Levin1, M W Fischman, I Connerney
1Department of Psychiatry, Columbia University/New York State Psychiatric Institute, New York 10032, USA.
The American Journal on Addictions
|April 1, 1997
Summary
Rapidly switching patients from methadone (METH) to buprenorphine (BUP) maintenance is feasible. Most participants tolerated the switch, experiencing moderate withdrawal symptoms that resolved within four days in a supportive inpatient setting.
Area of Science:
- Addiction Medicine
- Pharmacology
- Clinical Research
Background:
- Methadone (METH) maintenance is a standard treatment for opioid use disorder.
- Buprenorphine (BUP) offers an alternative, but data on switching from METH to BUP are limited.
- Understanding the tolerability of METH to BUP transitions is crucial for clinical practice.
Purpose of the Study:
- To evaluate the feasibility and tolerability of rapidly switching patients from high-dose methadone (METH) to buprenorphine (BUP).
- To assess withdrawal symptom severity during the METH to BUP transition.
- To determine the time course of symptom resolution after initiating BUP.
Main Methods:
- Eighteen METH-maintained volunteers participated in a residential cocaine self-administration study.
- Subjects received a 7-day switchover from METH (60 mg daily) to BUP (4 and 8 mg).
- Withdrawal symptoms were monitored using the Subjective Opiate Withdrawal Scale (SOWS).
Main Results:
- Fifteen of eighteen subjects (83%) successfully completed the METH to BUP switchover.
- Moderate withdrawal symptoms were observed, peaking at BUP administration.
- SOWS scores returned to baseline levels within four days post-switch.
Conclusions:
- Rapid switching from high-dose METH to BUP is a tolerable option within a supportive inpatient environment.
- The transition is associated with manageable withdrawal symptoms.
- This rapid switchover protocol may facilitate BUP initiation for patients on METH maintenance.