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The clinical use of buprenorphine in opiate addiction: evidence and practice

Published online by Cambridge University Press:  24 June 2014

Fergus D. Law ,
Judy S. Myles ,
Mark R. C. Daglish  and
David J. Nutt
Fergus D. Law*
Affiliation:
Avon and Wiltshire Mental Health Partnership NHS Trust, Bristol Specialist Drug Service, Cedar House, Blackberry Hill Hospital, Manor Road, Fishponds, Bristol, BS16 2EW, UK Psychopharmacology Unit, Division of Psychiatry, University of Bristol, Dorothy Hodgkin Building, Whitson Street, Bristol, BS1 3NY, UK
Judy S. Myles
Affiliation:
Department of Addictive Behaviour and Psychological Medicine, St Georges Medical School, 6th Floor Hunter Wing, Cranmer Terrace, London, SW17 ORE, UK
Mark R. C. Daglish
Affiliation:
Psychopharmacology Unit, Division of Psychiatry, University of Bristol, Dorothy Hodgkin Building, Whitson Street, Bristol, BS1 3NY, UK
David J. Nutt
Affiliation:
Psychopharmacology Unit, Division of Psychiatry, University of Bristol, Dorothy Hodgkin Building, Whitson Street, Bristol, BS1 3NY, UK
*
Fergus D. Law, BSc, MBChB, MRCPsych, Bristol Specialist Drug Service, Cedar House, Blackberry Hill Hospital, Manor Road, Fishponds, Bristol, BS16 2EW, UK. Tel: +44 117 9754840; Fax: +44 117 9586569; E-mail: [email protected]
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Abstract

Buprenorphine is a partial μ-opioid receptor agonist that is being increasingly used in clinical practice in the treatment of opioid dependence in the UK, USA, and, elsewhere. Its unique pharmacological properties mean it is a relatively safe drug, it can be given by alternate day dispensing, and it is associated with relatively mild symptoms on withdrawal. The interpretation of the research literature on buprenorphine is however, complex, and often appears to be in conflict with how buprenorphine is used in clinical practice. This article describes these apparent contradictions, their likely explanations, and how these may further inform our clinical practice. The article also describes the clinically relevant pharmacological properties of buprenorphine, compares it to methadone, relates the evidence to clinical experience, and provides practical advice on how to manage the most common clinical techniques. The best quality evidence suggests that very rapid buprenorphine induction is not associated with a higher drop-out rate than methadone, that buprenorphine is probably as good as methadone for maintenance treatment, and is superior to methadone and α-2 adrenergic agonists for detoxification. However, buprenorphine cannot yet be considered the ‘gold standard’ treatment for opiate dependence because of the higher drop-out rates that may occur on induction using current techniques, its high-cost relative to methadone, and because the place of buprenorphine in treatment is still continuing to evolve.

Keywords

α-2 adrenergic agonistsBuprenorphineclinicaldetoxificationmaintenancemethadoneopiatespartial μ-opioid receptor agonistSubutextreatment
Type
Original Article
Information
Acta Neuropsychiatrica , Volume 16 , Issue 5 , October 2004 , pp. 246 - 274
Copyright
Copyright © 2004 Blackwell Munksgaard

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References

Jasinski, DR, Henningfield, JE, Hickey, JE, Johnson, RE.Progress report of the NIDA Addiction Research Center. Baltimore, MD. In: Harris, LS, ed. Problems of Drug Dependence 1982: Proceedings of the 44th Annual Scientific Meeting of the Committee on Problems of Drug Dependence. NIDA Research Monograph, No. 43. DHHS, Rockville, MD: National Institute on Drug Abuse, 1983: 92–98.Google Scholar
Jasinski, DR, Boren, JJ, Henningfield, JE, Johnson, RE, Lange, WR, Lukas, SE.Progress report from the NIDA Addiction Research Center, Baltimore, MD. In: Harris, LS, ed. Problems of Drug Dependence 1983: Proceedings of the 45th Annual Scientific Meeting of the Committee on Problems of Drug Dependence. NIDA Research Monograph, No. 49. DHHS, Rockville, MD: National Institute on Drug Abuse, 1984: 69–76. Google Scholar
Kosten, TR, Kleber, HD.Buprenorphine detoxification from opigid dependence: a pilot study. Life Sci 1988;42: 635–641. CrossRefGoogle ScholarPubMed
Johnson, RE, Cone, EJ, Henningfield, JE, Fudala, PJ.Use of buprenorphine in the treatment of opiate addiction. I. Physiologic and behavioural effects during a rapid dose induction. Clin Pharmacol Ther 1989;46: 335–343. CrossRefGoogle ScholarPubMed
Johnson, RE, Jaffe, Jh, Fudala, PJ.A controlled trial of buprenorphine treatment for opioid dependence. JAMA 1992;267: 2750–2755. CrossRefGoogle ScholarPubMed
Kintz, P, Marquet, P.Buprenorphine therapy of opiate addiction. Forensic science and medicine series. Totowa, New Jersey: Humana Press, 2002. Google Scholar
Cowan, A, Lewis, JW, eds. Buprenorphine: Combatting drug abuse with a unique opioid. New York: Wiley-Liss, 1995. Google Scholar
Kintz, P.Buprenorphine-related death. In: Kintz, P, Marquet, P, eds. Forensic science and medicine: Buprenorphine therapy of opiate addiction. Totowa, New Jersey: Humana Press, 2002: 109–117. CrossRefGoogle Scholar
Auriacombe, M, Franques, P, Tignol, J.Deaths attributable to methadone vs buprenorphine in France. JAMA 2001;285: 45. CrossRefGoogle ScholarPubMed
Walsh, SL, Preston, KL, Stitzer, ML, Cone, EJ, Bigelow, GE.Clinical pharmacology of buprenorphine: ceiling effects at high doses. Clin Pharmacol Ther 1994;55: 569–580. CrossRefGoogle ScholarPubMed
Mattick, RP, Kimber, J, Breen, C, Davoli, M.Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence. The Cochrane database of systematic reviews 2003, Issue 3, Art. No.: CD002207. Pub2CrossRefGoogle Scholar
West, SL, O'Neal, KK, Graham, CW.A meta-analysis comparing the effectiveness of buprenorphine and methadone. J Subst Abuse 2000;12: 405–414. CrossRefGoogle ScholarPubMed
Barnett, PG, Rodgers, JH, Bloch, DA.A meta-analysis comparing buprenorphine to methadone for treatment of opiate dependence. Addiction 2001;96: 683–690. CrossRefGoogle ScholarPubMed
Gowing, L, Ali, R, White, J.Buprenorphine for the management of opioid withdrawal. The Cochrane database of systematic reviews 2004, Issue 4, Art. No.: CD002025. Pub2.CrossRefGoogle Scholar
Amass, L, Bickel, WK, Crean, JP, Blake, J, Higgins, ST.Alternate-day buprenorphine dosing is preferred to daily dosing by opioid-dependent humans. Psychopharmacology 1998;136: 217–225. CrossRefGoogle ScholarPubMed
Zubieta, J-K, Greenwald, MK, Lombardi, Uet al. Buprenorphine-induced changes in mu-opioid receptor availability in male heroin-dependent volunteers: a preliminary study. Neuropsychopharmacology 2000;23: 326–334. CrossRefGoogle ScholarPubMed
Bickel, WK, Stitzer, ML, Bigelow, GE, Liebson, IA, Jasinski, DR, Johnson, RE.Buprenorphine: dose-related blockade of opioid challenge effects in opioid dependent humans. J Pharmacol Exp Ther 1988;247: 47–53. Google ScholarPubMed
Lintzeris, N, Clark, N, Muhleisen, Pet al. National clinical guidelines and procedures for the use of Buprenorphine in the treatment of heroin dependence. Canberra, Australia: Department of Health and Aged Care, Commonwealth of Australia, 2001. Google Scholar
Ling, W.Buprenorphine: what's known, what's new and what's next? Res Clin Forums 2001;23: 11–17. Google Scholar
Johnson, RE, Strain, EC, Amass, L.Buprenorphine: how to use it right. Drug Alcohol Depend 2003;70 (Suppl. 2):S59–S77. CrossRefGoogle ScholarPubMed
Mallaret, M, Dematteis, M, Villier, C, Barjhoux, CE, Gatignol, C.Foreseeable advantages and limits of buprenorphine-naloxone association. In: Kintz, P, Marquet, P, eds. Forensic science and medicine: Buprenorphine therapy of opiate addiction. Totowa, New Jersey: Humana Press, 2002: 51–67. CrossRefGoogle Scholar
Heel, RC, Brogden, RN, Speight, TM, Avery, GS.Buprenorphine: a review of its pharmacological properties and therapeutic efficacy. Drugs 1979;17: 81–110. CrossRefGoogle ScholarPubMed
Walter, DS, Inturrisi, CE.Absorption, distribution, metabolism, and excretion of buprenorphine in animals and humans. In: Cowan, A, Lewis, JW, eds. Buprenorphine: combatting drug abuse with a unique opiate. New York: Wiley-Liss, 1995: 113–135. Google Scholar
Hambrook, JM, Rance, MJ.The interaction of buprenorphine with the opiate receptor. In: Kosterlitz, HW, ed. Opiates and endogenous opioid peptides. Amsterdam: Elsevier/North-Holland, 1976: 295–301. Google Scholar
Marquet, P.Pharmacology of high-dose buprenorphine. In: Kintz, P, Marquet, P, eds. Forensic science and medicine: Buprenorphine therapy of opiate addiction. Totowa, New Jersey: Humana Press, 2002: 1–11. Google Scholar
Chawarski, MC, Schottenfeld, RS, O'Connor, PG, Pakes, J.Plasma concentrations of buprenorphine 24–72 hours after dosing. Drug Alcohol Depend 1999;55: 157–163. CrossRefGoogle ScholarPubMed
McQuay, HJ, Bullingham, RES, Paterson, GM, Moore, RA.Clinical effects of buprenorphine during and after surgery. Br J Anaesth 1980;52: 1013–1019. CrossRefGoogle Scholar
Petry, NM, Bickel, WK, Badger, GJ.A comparison of four buprenorphine dosing regimens in the treatment of opioid dependence. Clin Pharmacol Ther 1999;66: 306–314. CrossRefGoogle ScholarPubMed
Huestis, MA.Controlled drug administration studies of high-dose buprenorphine in humans. In: Kintz, P, Marquet, P, eds. Forensic science and medicine: Buprenorphine therapy of opiate addiction. Totowa, New Jersey: Humana Press, 2002: 13–27. CrossRefGoogle Scholar
Bickel, WK, Amass, L, Crean, JP, Badger, GJ.Buprenorphine dosing every 1, 2, or 3 days in opioid-dependent patients. Psychopharmacology 1999;146: 111–118. CrossRefGoogle ScholarPubMed
Eissenberg, T, Johnson, RE, Bigelow, GEet al. Controlled opiate withdrawal evaluation during 72 h dose omission in buprenorphine-maintained patients. Drug Alcohol Depend 1997;45: 81–91. CrossRefGoogle ScholarPubMed
Nutt, DJ.Receptor pharmacology of buprenorphine. Res Clin Forums 1997;19: 9–15. Google Scholar
Walsh, SL, Eissenberg, T.Clinical pharmacology of buprenorphine: extrapolating from the laboratory to the clinic. Drug Alcohol Depend 2003;70 (Suppl. 2):S13–S27. CrossRefGoogle ScholarPubMed
Cone, EJ, Gorodetzky, CW, Yousefnejad, D, Buchwald, WF, Johnson, RE.The metabolism and excretion of buprenorphine in humans. Drug Metab Dispos 1984;12: 577–581. Google Scholar
Blom, Y, Bondesson, U, ÄNggård, E.Analysis of buprenorphine and its N-dealkylated metabolite in plasma and urine by selected-ion monitoring. J Chromatogr 1985;338: 89–98. CrossRefGoogle ScholarPubMed
Debrabandere, L, Van Boven, M, Daenens, P.Analysis of buprenorphine in urine specimens. J Forensic Sci 1992;37: 82–89. CrossRefGoogle ScholarPubMed
Johnson, RE, Jones, HE, Fischer, G.Use of buprenorphine in pregnancy: patient management and effects on the neonate. Drug Alcohol Depend 2003;70 (Suppl. 2):S87–S101. CrossRefGoogle ScholarPubMed
Fischer, G, Johnson, RE, Eder, Het al. Treatment of opioid-dependent pregnant women with buprenorphine. Addiction 2000;95: 239–244. CrossRefGoogle ScholarPubMed
Johnson, RE, Jones, HE, Jasinski, DRet al. Buprenorphine treatment of pregnant opioid-dependent women: maternal and neonatal outcomes. Drug Alcohol Depend 2001;63: 97–103. CrossRefGoogle ScholarPubMed
Lejeune, C, Aubisson, S, Simmat-Durand, L, Cneude, F, Piquet, M.Buprenorphine and pregnancy: a comparative, multicentre clinical study of high-dose buprenorphine versus methadone maintenance. In: Kintz, P, Marquet, P, eds. Forensic science and medicine: Buprenorphine therapy of opiate addiction. Totowa, New Jersey: Humana Press, 2002: 137–146. CrossRefGoogle Scholar
Fischer, G, Etzersdorfer, P, Eder, H, Jagsch, R, Langer, M, Weninger, M.Buprenorphine maintenance in pregnant opiate addicts. Eur Addict Res 1998;4 (Suppl. 1):32–36. CrossRefGoogle ScholarPubMed
Jasinski, DR, Pevnick, JS, Griffith, JD.Human pharmacology and abuse potential of the analgesic buprenorphine: a potential agent for treating narcotic addiction. Arch Gen Psychiatry 1978;35: 501–516. CrossRefGoogle ScholarPubMed
Soyka, M, Horak, M, Dittert, S, Kagerer, S.Less driving impairment on buprenorphine than methadone in drug-dependent patients. J Neuropsychiatry Clin Neurosci 2001;13: 527–528. CrossRefGoogle ScholarPubMed
Fischer, G, Gombas, W, Eder, Het al. Buprenorphine versus methadone maintenance for the treatment of opioid dependence. Addiction 1999;94: 1337–1347. CrossRefGoogle ScholarPubMed
Bodkin, JA, Zornberg, GL, Lukas, SE, Cole, JO.Buprenorphine treatment of refractory depression. J Clin Psychopharmacol 1995;15: 49–57. CrossRefGoogle ScholarPubMed
Nutt, D, Groves, S, Coupland, N, Glue, P.Buprenorphine in psychiatric disorders. In: Cowan, A, Lewis, JW, eds. Buprenorphine: combatting drug abuse with a unique opioid. New York: Wiley-Liss, 1995: 175–186. Google Scholar
Pollak, A.Die durchfuhrung einer substitutionbehandlung nach dem “Saarbrucken Modell”. [The implementation of a substitution therapy according to the “Saarbrücker Model”]. Suchtmedizin in Forschung und Praxis, Band 4. Heft 2002;1: 55–57. Google Scholar
Hand, CW, Sear, JW, Uppington, J, Ball, MJ, McQuay, HJ, Moore, RA.Buprenorphine disposition in patients with renal impairment: single and continuous dosing, with special reference to metabolites. Br J Anaesth 1990;64: 276–282. CrossRefGoogle ScholarPubMed
Summerfield, RJ, Allen, MC, Moore, RA, Sear, JW, McQuay, HJ.Buprenorphine in end stage renal failure. Anaesthesia 1985;40: 914. CrossRefGoogle ScholarPubMed
Lange, WR, Fudala, PJ, Dax, EM, Johnson, RE.Safety and side-effects of buprenorphine in the clinical management of heroin addiction. Drug Alcohol Depend 1990;26: 19–28. CrossRefGoogle ScholarPubMed
Petry, NM, Bickel, WK, Piasecki, D, Marsch, LA, Badger, GJ.Elevated liver enzyme levels in opioid dependent patients with hepatitis treated with buprenorphine. Am J Addict 2000;9: 265–269. CrossRefGoogle ScholarPubMed
Berson, A, Gervais, A, Cazals, Det al. Hepatitis after intravenous buprenorphine misuse in heroin addicts. J Hepatol 2001;34: 346–350. CrossRefGoogle ScholarPubMed
Noblet, C, Massy, N, Riachi, G, Biour, G, Thrillez, C.Liver injury caused by high dosage buprenorphine (HDB, Subutex®): a national investigation by the French pharmacovigilance system. Fundam Clin Pharmacol 2002;16: 417. Google Scholar
Berson, A, Fau, D, Fornacciari, Ret al. Mechanisms for experimental buprenorphine hepatotoxicity: major role of mitochondrial dysfunction versus metabolic activation. J Hepatol 2001;34: 261–269. CrossRefGoogle ScholarPubMed
Gueye, PN, Borron, SW, Risëde, Pet al. Buprenorphine and midazolam act in combination to depress respiration in rats. Toxicol Sci 2002;65: 107–114. CrossRefGoogle ScholarPubMed
Saarialho-Kere, U, Mattila, MJ, Paloheimo, M, Seppala, T.Psychomotor, respiratory and neuroendocrinological effects of buprenorphine and amitriptyline in healthy volunteers. Eur J Clin Pharmacol 1987;33: 139–146. CrossRefGoogle ScholarPubMed
Comer, SD, Collins, ED, Fischman, MW.Buprenorphine sublingual tablets: effects of IV heroin self-administration by humans. Psychopharmacology 2001; 154: 28–37. CrossRefGoogle ScholarPubMed
Iribarne, C, Picart, D, Dreano, Y, Bail, JP, Berthou, F.Involvement of cytochrome P450 3A4 in N-dealkylation of buprenorphine in human liver microsomes. Life Sci 1997;60: 1953–1964. CrossRefGoogle ScholarPubMed
Ibrahim, RB, Wilson, JG, Thorsby, ME, Edwards, DJ.Effects of buprenorphine on CYP3A activity in rat and human liver microsomes. Life Sci 2000;66: 1293–1298. CrossRefGoogle ScholarPubMed
Kobayashi, K, Yamamoto, T, Chiba, Ket al. Human buprenorphine N-dealkylation is catabolized by cytochrome P450 3A4. Drug Metab Dispos 1998;26: 818–821. Google ScholarPubMed
Eap, CB, Thierry, B, Baumann, P.Interindividual variability of the clinical pharmacokinetics of methadone: implications for the treatment of opioid dependence. Clin Pharmacokinet 2002;41: 1153–1193. CrossRefGoogle ScholarPubMed
McCance-Katz, EF, Rainey, PM, Friedland, G, Kosten, TR, Jatlow, P.Effect of opioid dependence pharmacotherapies on zidovudine disposition. Am J Addict 2001;10: 296–307.CrossRefGoogle ScholarPubMed
Iribarne, C, Picart, D, Dreano, Y, Berthou, F.In vitro interactions between fluoxetine or fluvoxamine and methadone or buprenorphine. Fundam Clin Pharmacol 1998;12: 194–199. CrossRefGoogle ScholarPubMed
Iribarne, C, Bethou, F, Carlhant, Det al. Inhibition of methadone and buprenorphine N-dealkylations by three HIV-1 protease inhibitors. Drug Metab Dispos 1998;26: 257–260. Google ScholarPubMed
Woolhouse, NM, Andoh, B, Mahgoub, A, Sloan, TP, Idle, JR, Smith, RL.Debrisoquin hydroxylation polymorphism among Ghanaians and Caucasians. Clin Pharmacol Ther 1979;26: 584–591. CrossRefGoogle ScholarPubMed
Kuhlman, JJ, Lalani, S, Magluilo, J, Levine, B, Darwin, WD.Human pharmacokinetics of intravenous, sublingual, and buccal buprenorphine. J Anal Toxicol 1996;20: 369–378. CrossRefGoogle ScholarPubMed
Mendelson, J, Upton, RA, Everhart, ET, Jacob, PJones, RT.Bioavailability of sublingual buprenorphine. J Clin Pharmacol 1997;37: 31–37. CrossRefGoogle ScholarPubMed
Strain, EC, Moody, DE, Stoller, KB, Walsh, SL, Bigelow, GE.Relative bioavailability of different buprenorphine formulations under chronic dosing conditions. Drug Alcohol Depend 2004;74: 37–43. CrossRefGoogle ScholarPubMed
Stoller, KB, Bigelow, GE, Walsh, SL, Strain, EC.Effects of buprenorphine/naloxone in opioid-dependent humans. Psychopharmacology 2001;154: 230–242. CrossRefGoogle ScholarPubMed
Chiang, CN, Hawks, RL.Pharmacokinetics of the combination tablet of buprenorphine and naloxone. Drug Alcohol Depend 2003;70 (Suppl. 2):S39–S47. CrossRefGoogle ScholarPubMed
Robinson, GM, Dukes, PD, Robinson, BJ, Cooke, RR, Mahoney, GN.The misuse of buprenorphine and a buprenorphine-naloxone combination in Wellington, New Zealand. Drug Alcohol Depend 1993;33: 81–86. CrossRefGoogle Scholar
Mendelson, J, Jones, RT.Clinical and pharmacological evaluation of buprenorphine and naloxone combinations: why the 4:1 ratio for treatment? Drug Alcohol Depend 2003;70 (Suppl. 2):S29–S37. CrossRefGoogle Scholar
Nath, RP, Upton, RA, Everhart, ETet al. Buprenorphine pharmacokinetics: relative bioavailability of sublingual tablet and liquid formulations. J Clin Pharmacol 1999;39: 619–623. CrossRefGoogle ScholarPubMed
Ford, C, Morton, S, Lintzeris, N, Bury, J, Gerada, C. Royal College of General Practitioners guidance for the use of buprenorphine for the treatment of opioid dependence in primary care. London and Manchester: RCGP and SMMGP, 2nd Ed. 2004. Google Scholar
DOH, Scottish Office DOH, Welsh Office, DOH & SocialServices Northern Ireland. Drug misuse and dependence – guidelines on clinical management. London: DOH, 1999. Google Scholar
Strang, J.Abuse of buprenorphine (Temgesic) by snorting. BMJ 1991;302: 969. CrossRefGoogle ScholarPubMed
Lavelle, TL, Hammmersley, R, Forsyth, A.The use of buprenorphine and temazepam by drug injectors. J Addict Dis 1991;10: 5–14. CrossRefGoogle ScholarPubMed
O'Connor, JJ, Moloney, E, Travers, R, Campbell, A.Buprenorphine abuse among opiate addicts. Br J Addict 1988;83: 1085–1087. CrossRefGoogle ScholarPubMed
Hammerseley, R, Lavelle, T, Forsyth, A.Buprenorphine and temazepam abuse. Br J Addict 1990;85: 301–303. CrossRefGoogle Scholar
Sakol, MS, Stark, C, Sykes, R.Buprenorphine and temazepam abuse by drug takers in Glasgow – an increase. Br J Addict 1989;84: 439–441. CrossRefGoogle ScholarPubMed
Strang, J.Abuse of buprenorphine. Lancet 1985;2: 725. CrossRefGoogle ScholarPubMed
Gray, RF, Ferry, A, Jauhar, P.Emergence of buprenorphine dependence. Br J Addict 1989;84: 1373–1374. CrossRefGoogle ScholarPubMed
Robertson, JR, Bucknall, ABV.Buprenorphine: dangerous drug or overlooked therapy? BMJ 1986; 292: 1465. CrossRefGoogle Scholar
Linhardt, K, Ravn, C, Gizurarson, S, Bechgaard, E.Intranasal absorption of buprenorphine – in vivo bioavailability in sheep. Int J Pharm 2000;205: 159–163. CrossRefGoogle Scholar
Ward, J, Mattick, RP, Hall, W.How long is enough? Answers to questions about the duration of methadone maintenance treatment. In: Ward, J, Mattick, RP, Hall, W, eds. Methadone maintenance treatment and other opioid replacement therapies. Amsterdam, the Netherlands: Harwood Academic Publishers, 1998: 305–336. Google Scholar
Obadia, Y, Perrin, V, Feroni, I, Vlahov, D, Moatti, J-P.Injecting misuse of buprenorphine among French drug users. Addiction 2001;96: 267–272. CrossRefGoogle ScholarPubMed
Petry, NM, Bickel, WK, Badger, GJ.A comparison of four buprenorphine dosing regimens using open-dosing procedures: is twice-weekly dosing possible? Addiction 2000;95: 1069–1077. CrossRefGoogle ScholarPubMed
Amass, L, Kamien, JB, Mikulich, SK.Efficacy of daily and alternate-day dosing regimens with the combination buprenorphine-naloxone tablet. Drug Alcohol Depend 2000;58: 143–152. CrossRefGoogle ScholarPubMed
Amass, L, Kamien, JB, Mikulich, SK.Thrice-weekly supervised dosing with the combination buprenorphine-naloxone tablet is preferred to daily supervised dosing by opioid-dependent humans. Drug Alcohol Depend 2001;61: 173–181. CrossRefGoogle ScholarPubMed
Perez de Los Cobos, J, Martin, S, Etcheberrigaray, Aet al. A controlled trial of daily versus thrice-weekly buprenorphine administration for the treatment of opioid dependence. Drug Alcohol Depend 2000;59: 223–233. CrossRefGoogle ScholarPubMed
Parran, TV, Adelman, CL, Jasinski, DR.A buprenorphine stabilization and rapid-taper protocol for the detoxification of opiate-dependent patients. Am J Addict 1994;3: 306–313. Google Scholar
Welsh, CJ, Suman, M, Cohen, A, Broyles, L, Bennett, M, Weintraub, E.The use of intravenous buprenorphine for the treatment of opioid withdrawal in medically ill hospitalized patients. Am J Addict 2002;11: 135–140. CrossRefGoogle ScholarPubMed
Preston, A.The methadone briefing. London: Institute for the Study of Drug Dependence (ISDD), 1996. Google Scholar
Ward, J, Mattick, RP, Hall, W.The use of methadone during maintenance treatment: pharmacology, dosage and treatment outcome. In: Ward, J, Mattick, RP, Hall, W, eds. Methadone maintenance treatment and other opioid replacement therapies. Amsterdam, the Netherlands: Harwood Academic Publishers, 1998: 205–238. Google Scholar
Bickel, WK, Amass, LA.Buprenorphine treatment of opioid dependence: a review. Exp Clin Psychopharmacol 1995;3: 477–489. CrossRefGoogle Scholar
Banks, A, Waller, TAN.Drug misuse: a practical handbook for GPs. Oxford: Blackwell Scientific Publications, 1988. Google Scholar
Seivewright, N.Community treatment of drug misuse: more than methadone. Cambridge: Cambridge University Press, 2000. Google Scholar
Bushnell, TG, Justins, DM.Choosing the right analgesic. A guide to selection. Drugs 1993;46: 394–408. CrossRefGoogle ScholarPubMed
Carnwath, T, Merrill, J.Dose equivalents in opioid substitution treatment. Int J Drug Policy 2002;13: 445–447. CrossRefGoogle Scholar
Strain, EC, Stitzer, ML, Liebson, IA, Bigelow, GE.Buprenorphine versus methadone in the treatment of opioid-dependent cocaine users. Psychopharmacology 1994;116: 401–406. CrossRefGoogle ScholarPubMed
Strain, EC, Stitzer, ML, Liebson, IA, Bigelow, GE.Comparison of buprenorphine and methadone in the treatment of opioid dependence. Am J Psychiatry 1994;151: 1025–1030. Google ScholarPubMed
Mattick, RP, Ali, R, White, JM, O'Brien, S, Wolk, S, Danz, C.Buprenorphine versus methadone maintenance therapy: a randomized double-blind trial with 405 opioid-dependent patients. Addiction 2003;98: 441–452. CrossRefGoogle ScholarPubMed
Scott, J, Winfield, A, Kennedy, E, Bond, C.Laboratory study of the effects of citric and ascorbic acids on injections prepared with brown heroin. Int J Drug Policy 2000;11: 417–422. CrossRefGoogle ScholarPubMed
Huizer, H.Analytical studies on illicit heroin. V. Efficacy of volatization during heroin smoking. Pharm Weekbl Sci 1987;9: 203–211. CrossRefGoogle Scholar
Jenkins, AJ, Keenan, RM, Henningfield, JE, Cone, EJ.Pharmacokinetics and pharmacodynamics of smoked heroin. J Anal Toxicol 1994;18: 317–330. CrossRefGoogle ScholarPubMed
Smolka, M, Schmidt, LG.The influence of heroin dose and route of administration on the severity of the opiate withdrawal syndrome. Addiction 1999;94: 1191–1198. CrossRefGoogle ScholarPubMed
Mo, BP, Way, EL.An assessment of inhalation as a mode of administration of heroin by addicts. J Pharmacol Exp Ther 1966;154: 142–151. Google ScholarPubMed
Kosten, TA, Jacobsen, LK, Kosten, TR.Severity of precipitated opiate withdrawal predicts drug dependence by DSM-III-R criteria. Am J Drug Alcohol Abuse 1989;15: 237–250. CrossRefGoogle ScholarPubMed
Andrews, HL, Himmelsbach, CK.Relation of intensity of the morphine abstinence syndrome to dosage. J Pharmacol Exp Ther 1944;81: 288–293. Google Scholar
Davies, JB, Baker, R.The impact of self-presentation and interviewer bias effects on self-reported heroin use. Br J Addict 1987;82: 907–912. CrossRefGoogle ScholarPubMed
Bale, RN, Van Stone, WW, Engelsing, TMJ, Zarcone, VP Jr, Kuldaa JM. The validity of self-reported heroin use. Int J Addict 1981;16: 1387–1398. CrossRefGoogle ScholarPubMed
Johns, R, Gossop, M.Prescribing methadone for the opiate addict: a problem of dosage conversion. Drug Alcohol Depend 1985;16: 61–66. CrossRefGoogle ScholarPubMed
Scholes, CF, Gonty, N, Trotman, IF.Methadone titration in opioid-resistant cancer pain. Eur J Cancer Care (Engl) 1999;8: 26–29. CrossRefGoogle ScholarPubMed
Strain, EC, Preston, KL, Liebson, IA, Bigelow, GE.Acute effects of buprenorphine, hydromorphone and naloxone in methadone-maintained volunteers. J Pharmacol Exp Ther 1992;261: 985–993. Google ScholarPubMed
Di Petta, G, D'Avria, VS, Sirico, Get al. Buprenorphine high-dose, long-term therapy: a new clinical approach to opiate alkaloid dependency. Conference poster presentation at “Safer options in the treatment of opioid dependence: understanding buprenorphine”. 28–29 April 2003, Edinburgh, Scotland. Google Scholar
Buntwal, N, Bearn, J, Gossop, M, Strang, J.Naltrexone and lofexidine combination treatment compared with conventional lofexidine treatment for in-patient opiate detoxification. Drug Alcohol Depend 2000;59: 183–188. CrossRefGoogle ScholarPubMed
Petitjean, S, Stohler, R, Deglon, JJet al. Double blind randomised trial of buprenorphine and methadone in opiate dependence. Drug Alcohol Depend 2001;62: 97–104. CrossRefGoogle ScholarPubMed
Boas, RA, Villiger, JW.Clinical actions of fentanyl and buprenorphine. The significance of receptor binding. Br J Anaesth 1985;57: 192–196. CrossRefGoogle ScholarPubMed
Cowan, A.Update on the general pharmacology of buprenorphine. In: Cowan, A, Lewis, JW, eds. Buprenorphine: combatting drug abuse with a unique opioid. New York: Wiley-Liss, 1995: 31–47. Google Scholar
Tracqui, A, Kintz, P, Ludes, B.Buprenorphine-related deaths among drug addicts in France: a report on 20 fatalities. J Anal Toxicol 1998;22: 430–434. CrossRefGoogle Scholar
Tracqui, A, Tournoud, C, Flesch, Fet al. Acute poisoning during substitution therapy based on high-dosage buprenorphine. 29 clinical cases – 20 fatal cases [In French]. Presse Med 1998;27: 557–561. Google ScholarPubMed
Reynaud, M, Petit, G, Potard, D, Courty, P.Six deaths linked to concomitant use of buprenorphine and benzodiazepines. Addiction 1998;93: 1385–1392. CrossRefGoogle ScholarPubMed
Gaulier, JM, Marquet, P, Lacassie, E, Dupuy, JL, Lachatre, G.Fatal intoxication following self-administration of a massive dose of buprenorphine. J Forensic Sci 2000;45: 226–228. CrossRefGoogle ScholarPubMed
Ohtani, M, Kotaki, H, Nishitateno, K, Sawada, Y, Iga, T.Kinetics of respiratory depression in rats induced by buprenorphine and its metabolite, norbuprenorphine. J Pharmacol Exp Ther 1997;281: 428–433. Google ScholarPubMed
Rothman, RB, Ni, Q, Xu, H.Buprenorphine: a review of the binding literature. In: Cowan, A, Lewis, JW, eds. Buprenorphine: combatting drug abuse with a unique opioid. New York: Wiley-Liss, 1995: 19–29. Google Scholar
Thörn, S-E, Rawal, N, Wennhager, M.Prolonged respiratory depression caused by sublingual buprenorphine. Lancet 1988;23: 179–180. CrossRefGoogle Scholar
Gal, JT.Naloxone reversal of buprenorphine-induced respiratory depression. Clin Pharmacol Ther 1989;45: 66–71. CrossRefGoogle ScholarPubMed
Zacny, JP, Conley, K, Galinkin, J.Comparing the subjective, psychomotor and physiological effects of intravenous buprenorphine and morphine in healthy volunteers. J Pharmacol Exp Ther 1997;282: 1187–1197. Google ScholarPubMed
Rosen, M, Kosten, TR.Detoxification and induction onto naltrexone. In: Cowan, A, Lewis, JW, eds. Buprenorphine: combatting drug abuse with a unique opioid. New York: Wiley-Liss, 1995: 289–305. Google Scholar
Lewis, JW. Buprenorphine. Drug Alcohol Depend 1985;14: 363–372. CrossRefGoogle ScholarPubMed
Dum, J, Bläsig, J, Herz, A.Buprenorphine: demonstration of physical dependence liability. Eur J Pharmacol 1981;70: 293–300. CrossRefGoogle ScholarPubMed
Mello, NK, Mendelson, JH, Kuehnle, JC.Buprenorphine effects on human heroin self-administration: an operant analysis. J Pharmacol Exp Ther 1982;223: 30–39. Google ScholarPubMed
Clark, NC, Lintzeris, N, Muhleisen, PJ.Severe opiate withdrawal in a heroin user precipitated by a massive buprenorphine dose. Med J Aust 2002;176: 166–167. Google Scholar
Kosten, TR, Morgan, C, Kleber, HD.Treatment of heroin addicts using buprenorphine. Am J Drug Alcohol Abuse 1991;17: 119–128. CrossRefGoogle ScholarPubMed
Mendelson, J, Jones, RT, Fernandez, I, Welm, S, Melby, AK, Baggott, MJ.Buprenorphine and naloxone interactions in opiate-dependent volunteers. Clin Pharmacol Ther 1996;60: 105–114. CrossRefGoogle ScholarPubMed
Law, FD, Bailey, JE, Allen, DSet al. The feasibility of abrupt methadone-buprenorphine transfer in British opiate addicts in an out-patient setting. Addict Biol 1997;2: 191–200. CrossRefGoogle Scholar
Dum, JE, Herz, A.In vivo receptor binding of the opiate partial agonist, buprenorphine, correlated with its agonistic and antagonistic actions. Br J Pharmacol 1981;74: 627–633. CrossRefGoogle ScholarPubMed
Neil, A.Affinities of some common opioid analgesics towards four binding sites in mouse brain. Naunyn Schmeidebergs Arch Pharmacol 1984;328: 24–29. CrossRefGoogle ScholarPubMed
Umbricht, A, Montoya, ID, Hoover, DR, Demuth, KL, Chiang, CT, Preston, KL.Naltrexone shortened opioid detoxification with buprenorphine. Drug Alcohol Depend 1999;56: 181–190. CrossRefGoogle ScholarPubMed
O'Connor, PG, Carroll, KM, Shi, JM, Schottenfeld, RS, Kosten, TR, Rounsaville, BJ.Three methods of opioid detoxification in a primary care setting: a randomized trial. Ann Intern Med 1997;127: 526–530. CrossRefGoogle Scholar
Van Dyck, CH, Rosen, MI, Thomas, HMet al. SPECT regional cerebral blood flow alterations in naltrexone-precipitated withdrawal from buprenorphine. Psychiatry Res 1994;55: 181–191. CrossRefGoogle ScholarPubMed
Kosten, TR, Krystal, JH, Charney, DS, Price, LH, Morgan, CH, Kleber, HD.Opioid antagonist challenges in buprenorphine maintained patients. Drug Alcohol Depend 1990;25: 73–78. CrossRefGoogle ScholarPubMed
Eissenberg, T, Greenwald, MK, Johnson, RE, Liebson, IA, Bigelow, GE, Stitzer, ML.Buprenorphine's physical dependence potential: antagonist-precipitated withdrawal in humans. J Pharmacol Exp Ther 1996;276: 449–459. Google ScholarPubMed
Bouchez, J, Beauverie, P, Touzeau, D.Substitution with buprenorphine in methadone and morphine sulfate-dependent patients: preliminary results. Eur Addict Res 1998;4(Suppl.1):8–12. CrossRefGoogle ScholarPubMed
Breen, CL, Harris, SJ, Lintzeris, Net al. Cessation of methadone maintenance treatment using buprenorphine: transfer from methadone to buprenorphine and subsequent buprenorphine reductions. Drug Alcohol Depend 2003;71: 49–55. CrossRefGoogle ScholarPubMed
Levin, FR, Fischman, MW, Connerney, I, Foltin, RW.A protocol to switch high-dose, methadone-maintained subjects to buprenorphine. Am J Addict 1997;6: 105–116. Google ScholarPubMed
Walsh, SL, June, HL, Schuh, KJ, Preston, KL, Bigelow, GE, Stitzer, ML.Effects of buprenorphine and methadone in methadone-maintained subjects. Psychopharmacology 1995;119: 268–276. CrossRefGoogle ScholarPubMed
Kakko, J, Svanborg, KD, Kreek, MJ, Heilig, M.1-year retention and social function after buprenorphine-assisted relapse prevention treatment for heroin dependence in Sweden: a randomised, placebo-controlled trial. Lancet 2003;361: 662–668. CrossRefGoogle ScholarPubMed
Law, FD, Nutt, DJ.Maintenance buprenorphine for opioid users. Lancet 2003;361: 634–635. CrossRefGoogle ScholarPubMed
Lintzeris, N, Bell, J, Bammer, G, Jolley, DJ, Rushworth, L.A randomized controlled trial of buprenorphine in the management of short-term ambulatory heroin withdrawal. Addiction 2002;97: 1395–1404. CrossRefGoogle ScholarPubMed
Johnson, RE, Chutuape, MA, Strain, EC, Walsh, SL, Stitzer, ML, Bigelow, GE.A comparison of levomethadyl acetate, buprenorphine and methadone for opioid dependence. N Engl J Med 2000;343: 1290–1297. CrossRefGoogle ScholarPubMed
Hawkins, JD.Community characteristics associated with treatment outcome. In: Cooper, JR, Altman, F, Brown, BS, Czechowicz, D, eds. Research on the treatment of narcotic addiction: state of the art. Rockville, MD: National Institute on Drug Abuse, 1983: 680–713. Google Scholar
McLellan, AT.Patient characteristics associated with outcome. In: Cooper, JR, Altman, F, Brown, BS, Czechowicz, D, eds. Research on the treatment of narcotic addiction: state of the art. Rockville, MD: National Institute on Drug Abuse, 1983: 500–540. Google Scholar
Woody, GE.Treatment characteristics associated with outcome. In: Cooper, JR, Altman, F, Brown, BS, Czechowicz, D, eds. Research on the treatment of narcotic addiction: state of the art. Rockville, MD: National Institute on Drug Abuse, 1983: 541–574. Google Scholar
D'Amanda, C.Program policies and procedures associated with treatment outcome. In: Cooper, JR, Altman, F, Brown, BS, Czechowicz, D, eds. Research on the treatment of narcotic addiction: state of the art. Rockville, MD: National Institute on Drug Abuse, 1983: 637–679. Google Scholar
Fudala, PJ, Jaffe, JH, Dax, EM, Johnson, RE.Use of buprenorphine in the treatment of opiate addiction. II. Physiologic and behavioural effects of daily and alternate-day administration and abrupt withdrawal. Clin Pharmacol Ther 1990;47: 525–534. CrossRefGoogle ScholarPubMed
San, L, Camì, J, Fernández, T, Ollé, JM, Peri, JM, Torrens, M.Assessment and management of opiate withdrawal symptoms in buprenorphine-dependent subjects. Br J Addict 1992;87: 55–62. CrossRefGoogle ScholarPubMed
Ohtani, M, Kotaki, H, Uchino, K, Sawada, Y, Iga, T.Pharmacokinetic analysis of enterohepatic circulation of buprenorphine and its active metabolite, norbuprenorphine, in rats. Drug Metab Dispos 1994;22: 2–7. Google ScholarPubMed
Rosow, CE.Buprenorphine: epidural and intrathecal use. In: Cowan, A, Lewis, JW, eds. Buprenorphine: combatting drug abuse with a unique opioid. New York: Wiley-Liss, 1995: 165–174. Google Scholar
Lintzeris, N.Buprenorphine dosing regime in the management of out-patient heroin withdrawal. Drug Alcohol Rev 2002;21: 39–45. CrossRefGoogle ScholarPubMed
Bickel, WK, Amass, L, Higgins, ST, Badger, GJ, Esch, RA.Effects of adding behavioural treatment to opiate detoxification with buprenorphine. J Consult Clin Psychol 1997;65: 803–810. CrossRefGoogle ScholarPubMed
Bickel, WK, Stitzer, ML, Bigelow, GE, Liebson, IA, Jasinski, DR, Johnson, RE.A clinical trial of buprenorphine: comparison with methadone in the detoxification of heroin addicts. Clin Pharmacol Ther 1988;43: 72–78. CrossRefGoogle ScholarPubMed
Nigam, AK, Ray, R, Tripathi, BM.Buprenorphine in opiate withdrawal: a comparison with clonidine. J Subst Abuse Treat 1993;10: 391–394. CrossRefGoogle ScholarPubMed
Cheskin, LJ, Fudala, PJ, Johnson, RE.A controlled comparison of buprenorphine and clonidine for acute detoxification from opioids. Drug Alcohol Depend 1994;36: 115–121. CrossRefGoogle ScholarPubMed
Janiri, L, Mannelli, P, Persico, AM, Serretti, A, Tempesta, E.Opiate detoxification of methadone maintenance patients using lefetamine, clonidine and buprenorphine. Drug Alcohol Depend 1994;36: 139–145. CrossRefGoogle ScholarPubMed
Law, FD, Myles, J, Nutt, DJ.BD RCT of Suboxone (buprenorphine/naloxone) vs methadone/lofexidine for stabilization and withdrawal of low dose outpatient opiate addicts. Drug Alcohol Depend 2002;66: S100. Google Scholar
White, R.Two methods of community detoxification from opiates: an open label comparison of lofexidine and buprenorphine. Drug Alcohol Depend 2001;65: 77–83. CrossRefGoogle ScholarPubMed
Barnett, PG, Zaric, GS, Brandeau, ML.The cost-effectiveness of buprenorphine maintenance therapy for opiate addiction in the United States. Addiction 2000;96: 1267–1278. CrossRefGoogle Scholar
Rosenheck, R, Kosten, T.Buprenorphine for opiate addiction: potential economic impact. Drug Alcohol Depend 2001;63: 253–262. CrossRefGoogle ScholarPubMed