Community Resource for Patients and Families: Buprenorphine (Detoxification)

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A Randomized, Double-Blind Evaluation of Buprenorphine Taper Duration In Primary Prescription Opioid Abusers.

Category:  Buprenorphine (Detoxification)

Last Update:  04/13/14 (Dr. Maria Sullivan, MD, PhD and Danielle M. Simpson, MS I)

Findings:

For patients detoxing from prescription opioid use disorder, buprenorphine doses should be gradually reduced over a period of four or more weeks, instead of more quickly over a shorter period of time.

In a 12-week double-blind outpatient clinical trial, prescription opioid-dependent patients (N=70) were stabilized on buprenorphine for two weeks. Buprenorphine is an agonist treatment (has opioid effects) that has been proven to be effective in recovery from prescription opioid addiction. Then researchers studied the timing of tapering off buprenorphine that was most likely to succeed in opioid detoxification. Participants reduced their doses of buprenorphine over a period of 1, 2, or 4 weeks. Patients also began to receive oral naltrexone (a drug that blocks the effects of opioids in the body and helps prevent relapse) and continued behavioral therapy. Patients who gradually reduced their dose of buprenorphine over a 4-week period had higher rates of remaining abstinent from opioids after detoxification than did patients with a shorter “taper” time of 1 or 2 weeks.  Patients who successfully detoxed were maintained on daily oral naltrexone to prevent relapse.

Reference:

Sigmon SC, Dunn KE, Saulsgiver K, Patrick ME, Badger GJ, Heil SH, Brooklyn JR, Higgins ST. (2013).  A randomized, double-blind evaluation of buprenorphine taper duration in primary prescription opioid abusers. JAMA Psychiatry, 70(12): 1347-1354.