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Buprenorphine detoxification treatment for heroin dependence: a preliminary experience in an outpatient setting

Published online by Cambridge University Press:  13 June 2014

Hugh Williams ,
Andrew Remedios ,
Adenekan Oyefeso  and
Jennifer Bennett
Hugh Williams
Affiliation:
Substance Misuse Service, South Downs Health NHS Trust, Brighton BN1 4SF, Honorary Senior Lecturer, Department of Addictive Behaviour and Psychological Medicine, St George's Hospital Medical School, London SW17 ORE, England
Andrew Remedios
Affiliation:
Substance Misuse Service, South Downs Health NHS Trust, Brighton BN1 4SF, England
Adenekan Oyefeso
Affiliation:
Department of Addictive Behaviour and Psychological Medicine, St George's Hospital Medical School, London SW17 ORE, England
Jennifer Bennett
Affiliation:
East Sussex Brighton & Hove Health Authority, 36-38 Friars Walk, Lewes BN7 2PB, England
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Abstract

Objectives: The aim of the study was to evaluate buprenorphine as a detoxification agent for heroin dependence in an outpatient setting. Specifically we sought to establish the rate of completion of detoxification and retention in treatment, the duration of successful detoxification and dose requirements.

Methods: The study was an open prospective evaluation of routinely collected clinical data on the first 60 consecutive heroin dependent patients who underwent buprenorphine detoxification. A flexible dosing regime was adopted with the dose of buprenorphine being adjusted daily against the previous day's withdrawal symptoms.

Results: The majority of patients (40 (67%)) completed detoxification. The median duration of treatment for completers was 17 days (range 9-30 days) with 90% of detoxification episodes completed within 21 days. Patients were commenced on initial median dose of 4mg buprenorphine (range 2mg-6mg) and the median stabilisation dose for the sample was 10mg daily (range 6mg-14mg). The median final dosage of buprenorphine required by patients retained in treatment was 1.2mg (range 0.4mg-2mg). We found older patient age to be a significant predictor of treatment completion.

Conclusions: Buprenorphine was an acceptable and a feasible outpatient detoxification treatment option for heroin dependent patients. Based on the study findings we propose a standard 21-day fixed-dose detoxification schedule.

Keywords

BuprenorphineOpiate dependenceDetoxificationOutpatient
Type
Original Papers
Information
Irish Journal of Psychological Medicine , Volume 19 , Issue 3 , September 2002 , pp. 80 - 83
Copyright
Copyright © Cambridge University Press 2002

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