Buprenorphine tapering schedule and illicit opioid use

Walter Ling, Maureen Hillhouse, Catherine Domier, Geetha Doraimani, Jeremy Hunter, Christie Thomas, Jessica Jenkins, Albert Hasson, Jeffrey Annon, Andrew Saxon, Jeffrey Selzer, Joshua Boverman, Richard Bilangi

Research output: Contribution to journalArticle

75 Citations (Scopus)

Abstract

Aims: To compare the effects of a short or long taper schedule after buprenorphine stabilization on participant outcomes as measured by opioid-free urine tests at the end of each taper period. Design: This multi-site study sponsored by Clinical Trials Network (CTN, a branch of the US National Institute on Drug Abuse) was conducted from 2003 to 2005 to compare two taper conditions (7 days and 28 days). Data were collected at weekly clinic visits to the end of the taper periods, and at 1-month and 3-month post-taper follow-up visits. Setting: Eleven out-patient treatment programs in 10 US cities. Intervention: Non-blinded dosing with Suboxone® during the 1-month stabilization phase included 3 weeks of flexible dosing as determined appropriate by the study physicians. A fixed dose was required for the final week before beginning the taper phase. Measurements: The percentage of participants in each taper group providing urine samples free of illicit opioids at the end of the taper and at follow-up. Findings: At the end of the taper, 44% of the 7-day taper group (n = 255) provided opioid-free urine specimens compared to 30% of the 28-day taper group (n = 261; P = 0.0007). There were no differences at the 1-month and 3-month follow-ups (7-day = 18% and 12%; 28-day = 18% and 13%, 1 month and 3 months, respectively). Conclusion: For individuals terminating buprenorphine pharmacotherapy for opioid dependence, there appears to be no advantage in prolonging the duration of taper.

Original languageEnglish (US)
Pages (from-to)256-265
Number of pages10
JournalAddiction
Volume104
Issue number2
DOIs
StatePublished - Feb 2009

Fingerprint

Buprenorphine
Opioid Analgesics
Appointments and Schedules
Urine
National Institute on Drug Abuse (U.S.)
Ambulatory Care
Outpatients
Clinical Trials
Physicians
Drug Therapy
Therapeutics

Keywords

  • Buprenorphine
  • Buprenorphine taper
  • Opioid dependence
  • Opioids
  • Treatment

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Psychiatry and Mental health

Cite this

Ling, W., Hillhouse, M., Domier, C., Doraimani, G., Hunter, J., Thomas, C., ... Bilangi, R. (2009). Buprenorphine tapering schedule and illicit opioid use. Addiction, 104(2), 256-265. https://doi.org/10.1111/j.1360-0443.2008.02455.x

Buprenorphine tapering schedule and illicit opioid use. / Ling, Walter; Hillhouse, Maureen; Domier, Catherine; Doraimani, Geetha; Hunter, Jeremy; Thomas, Christie; Jenkins, Jessica; Hasson, Albert; Annon, Jeffrey; Saxon, Andrew; Selzer, Jeffrey; Boverman, Joshua; Bilangi, Richard.

In: Addiction, Vol. 104, No. 2, 02.2009, p. 256-265.

Research output: Contribution to journalArticle

Ling, W, Hillhouse, M, Domier, C, Doraimani, G, Hunter, J, Thomas, C, Jenkins, J, Hasson, A, Annon, J, Saxon, A, Selzer, J, Boverman, J & Bilangi, R 2009, 'Buprenorphine tapering schedule and illicit opioid use', Addiction, vol. 104, no. 2, pp. 256-265. https://doi.org/10.1111/j.1360-0443.2008.02455.x
Ling W, Hillhouse M, Domier C, Doraimani G, Hunter J, Thomas C et al. Buprenorphine tapering schedule and illicit opioid use. Addiction. 2009 Feb;104(2):256-265. https://doi.org/10.1111/j.1360-0443.2008.02455.x
Ling, Walter ; Hillhouse, Maureen ; Domier, Catherine ; Doraimani, Geetha ; Hunter, Jeremy ; Thomas, Christie ; Jenkins, Jessica ; Hasson, Albert ; Annon, Jeffrey ; Saxon, Andrew ; Selzer, Jeffrey ; Boverman, Joshua ; Bilangi, Richard. / Buprenorphine tapering schedule and illicit opioid use. In: Addiction. 2009 ; Vol. 104, No. 2. pp. 256-265.
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AB - Aims: To compare the effects of a short or long taper schedule after buprenorphine stabilization on participant outcomes as measured by opioid-free urine tests at the end of each taper period. Design: This multi-site study sponsored by Clinical Trials Network (CTN, a branch of the US National Institute on Drug Abuse) was conducted from 2003 to 2005 to compare two taper conditions (7 days and 28 days). Data were collected at weekly clinic visits to the end of the taper periods, and at 1-month and 3-month post-taper follow-up visits. Setting: Eleven out-patient treatment programs in 10 US cities. Intervention: Non-blinded dosing with Suboxone® during the 1-month stabilization phase included 3 weeks of flexible dosing as determined appropriate by the study physicians. A fixed dose was required for the final week before beginning the taper phase. Measurements: The percentage of participants in each taper group providing urine samples free of illicit opioids at the end of the taper and at follow-up. Findings: At the end of the taper, 44% of the 7-day taper group (n = 255) provided opioid-free urine specimens compared to 30% of the 28-day taper group (n = 261; P = 0.0007). There were no differences at the 1-month and 3-month follow-ups (7-day = 18% and 12%; 28-day = 18% and 13%, 1 month and 3 months, respectively). Conclusion: For individuals terminating buprenorphine pharmacotherapy for opioid dependence, there appears to be no advantage in prolonging the duration of taper.

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