Buprenorphine treatment of prescription opiate addiction.

This presentation begins with an overview of opiate use in Sacramento, California, which experienced a 40% increase in opiate abusers in publicly funded drug treatment programs between the years of 2006-2008. Forty-seven percent of this population were using prescription opiates, such as oxycodone and hydrocodone. The CTN START study (protocol CTN-0027: Starting Treatment with Agonist Replacement Therapies) compared buprenorphine with methadone for opiate addiction treatment, with a particular focus on liver function.

The California/Arizona node (Bi-Valley Medical Clinic, Inc., in particular) participated in this project and found that retention in its site, as well as the 9 others in the study, was significantly better for those on methadone than those on buprenorphine. This was a very different outcome from a study done in another private clinic in California, which found retention for opiate users to be very good when treated with buprenorphine. A follow-up study being conducted at UCLA, the START Retention Study, is looking at what factors may have contributed to the differences in these retention patterns. Overall, however, it appears that buprenorphine is well tolerated and very effective in a maintenance model of care. Analgesic and psychotropic effects of buprenorphine may be important in its efficacy.

Related protocols: CTN-0027