Controlled trial of maintenance treatment of intravenous buprenorphine dependence

Background Buprenorphine dependence is a relatively novel addiction. Aims To compare the treatment outcome in three groups over 12-weeks of treatment. Methods Two hundred and four intravenous (IV)-buprenorphine-dependent patients were randomised into three groups. Subjects received 50mg oral methadone tablet, or 5mg sublingual buprenorphine tablet, or 50mg oral naltrexone, and a weekly 30-minute clinical counselling session. Results The majority (80%) had a history of opium or heroin dependency before they were introduced to IV buprenorphine. The main source of buprenorphine for misusers was street sale (91%). The mean duration of buprenorphine dependence was 1.9 years and the mean dose per day was 3.9 ampoules (1 ampoule contains 0.3mg of buprenorphine in 1 ml). Overall 59% of the patients completed the 12-week study. Retention in the 50mg methadone group was significantly better than the 5mg dose buprenorphine group (p=0.001) and the 50mg dose naltrexone group (p=0.000). Retention in the 5mg buprenorphine group was significantly better than the 50mg naltrexone dose group (P=0.000). Conclusions These results support the efficacy and safety of oral methadone and sublingual buprenorphine tablets for injection buprenorphine-dependent patients.