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Short-Term Opioid Withdrawal Using Buprenorphine: Evidence from Research

Why Focus on Medically-Assisted Withdrawal (Detoxification)
In 2002, Buprenorphine was approved by the Food and Drug Administration for the treatment of opioid dependence. Yet, little data have been generated for the shorter term use of Buprenorphine/naloxone for medically assisted opioid withdrawal. The diversity of clinics in the NIDA CTN provided an unparalleled opportunity to conduct such a clinical endeavor (see Community Treatment Programs figure). The results of the CTN studies suggest that Buprenorphine is substantially better than clonidine for opioid detoxification.

What Were the Outcomes?

• The Buprenorphine/naloxone taper intervention was successful in both outpatient and inpatient settings.
• Buprenorphine/naloxone was superior to clonidine in both settings.
• 76% of patients tested opioid-negative in the inpatient setting (vs. 22% for clonidine patients).
• 29% of patients tested opioid-negative in the outpatient setting (vs. 5% for clonidine patients).

The percentage of patients present and testing opioid-negative were lower in outpatient settings than in inpatient settings. Given the contained nature of inpatient settings, this difference was expected by researchers conducting the studies. In outpatient settings, patients are in contact with more factors that can pull them away from their treatment. In spite of this difference, the results are still dramatic.

Articles

• A multi-center randomized trial of buprenorphine – naloxone versus clonidine for opioid detoxification: Findings from the National Institute on Drug Abuse Clinical Trials Network, Ling et al. Addiction article
• Bringing buprenorphine-naloxone detoxification to community treatment providers: The NIDA Clinical Trials Network field experience, Amass et al. American Journal on Addictions article

For additional resources highlighting research related to buprenorphine detoxification, please see the "Other Resources" section.