Bringing Buprenorphine-Naloxone Detoxification to Community Treatment Providers: The NIDA Clinical Trials Network Field Experience

Leslie Amass, Walter Ling, Thomas E. Freese, Chris Reiber, Jeffrey J. Annon, Allan J. Cohen, Dennis McCarty, Malcolm S. Reid, Lawrence S. Brown, Cynthia Clark, Douglas M. Ziedonis, Jonathan Krejci, Susan Stine, Theresa Winhusen, Greg Brigham, Dean Babcock, Joan A. Muir, Betty J. Buchan, Terry Horton

Research output: Contribution to journalArticle

116 Citations (Scopus)

Abstract

In October 2002, the U.S. Food and Drug Administration approved buprenorphine-naloxone (Suboxone®) sublingual tablets as an opioid dependence treatment available for use outside traditionally licensed opioid treatment programs. The NIDA Center for Clinical Trials Network (CTN) sponsored two clinical trials assessing buprenorphine-naloxone for short-term opioid detoxification. These trials provided an unprecedented field test of its use in twelve diverse community-based treatment programs. Opioid-dependent men and women were randomized to a thirteen-day buprenorphine-naloxone taper regimen for short-term opioid detoxification. The 234 buprenorphine-naloxone patients averaged 37 years old and used mostly intravenous heroin. Direct and rapid induction onto buprenorphine-naloxone was safe and well tolerated. Most patients (83%) received 8 mg buprenorphine-2 mg naloxone on the first day and 90% successfully completed induction and reached a target dose of 16mg buprenorphine-4 mg naloxone in three days. Medication compliance and treatment engagement was high. An average of 81% of available doses was ingested, and 68% of patients completed the detoxification. Most (80.3%) patients received some ancillary medications with an average of 2.3 withdrawal symptoms treated. The safety profile of buprenorphine-naloxone was excellent. Of eighteen serious adverse events reported, only one was possibly related to buprenorphine-naloxone. All providers successfully integrated buprenorphine-naloxone into their existing treatment milieus. Overall, data from the CTN field experience suggest that buprenorphine-naloxone is practical and safe for use in diverse community treatment settings, including those with minimal experience providing opioid-based pharmacotherapy and/or medical detoxification for opioid dependence.

Original languageEnglish (US)
JournalAmerican Journal on Addictions
Volume13
Issue numberSUPPL. 1
DOIs
StatePublished - 2004

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Clinical Trials
Opioid Analgesics
Therapeutics
Buprenorphine
Naloxone
Naloxone Drug Combination Buprenorphine
N-nitrosoiminodiacetic acid
Substance Withdrawal Syndrome
Medication Adherence
Heroin
United States Food and Drug Administration
Tablets
Safety
Drug Therapy

ASJC Scopus subject areas

  • Medicine (miscellaneous)

Cite this

Bringing Buprenorphine-Naloxone Detoxification to Community Treatment Providers : The NIDA Clinical Trials Network Field Experience. / Amass, Leslie; Ling, Walter; Freese, Thomas E.; Reiber, Chris; Annon, Jeffrey J.; Cohen, Allan J.; McCarty, Dennis; Reid, Malcolm S.; Brown, Lawrence S.; Clark, Cynthia; Ziedonis, Douglas M.; Krejci, Jonathan; Stine, Susan; Winhusen, Theresa; Brigham, Greg; Babcock, Dean; Muir, Joan A.; Buchan, Betty J.; Horton, Terry.

In: American Journal on Addictions, Vol. 13, No. SUPPL. 1, 2004.

Research output: Contribution to journalArticle

Amass, L, Ling, W, Freese, TE, Reiber, C, Annon, JJ, Cohen, AJ, McCarty, D, Reid, MS, Brown, LS, Clark, C, Ziedonis, DM, Krejci, J, Stine, S, Winhusen, T, Brigham, G, Babcock, D, Muir, JA, Buchan, BJ & Horton, T 2004, 'Bringing Buprenorphine-Naloxone Detoxification to Community Treatment Providers: The NIDA Clinical Trials Network Field Experience', American Journal on Addictions, vol. 13, no. SUPPL. 1. https://doi.org/10.1080/10550490490440807
Amass, Leslie ; Ling, Walter ; Freese, Thomas E. ; Reiber, Chris ; Annon, Jeffrey J. ; Cohen, Allan J. ; McCarty, Dennis ; Reid, Malcolm S. ; Brown, Lawrence S. ; Clark, Cynthia ; Ziedonis, Douglas M. ; Krejci, Jonathan ; Stine, Susan ; Winhusen, Theresa ; Brigham, Greg ; Babcock, Dean ; Muir, Joan A. ; Buchan, Betty J. ; Horton, Terry. / Bringing Buprenorphine-Naloxone Detoxification to Community Treatment Providers : The NIDA Clinical Trials Network Field Experience. In: American Journal on Addictions. 2004 ; Vol. 13, No. SUPPL. 1.
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