A recent clinical trial tested the drug Suboxone for opioid dependence. Long-term use of Suboxone helped patients to transition off of opioids, but later relapse was still prevalent.
"Talk to your doctor about treatment options for drug abuse."
Roger Weiss, MD, chief of the alcohol and drug abuse treatment program at McLean Hospital, led a clinical trial to see if the prescription drug buprenorphine-naloxone, brand name Suboxone, could be used to treat opioid dependence.
A total of 653 treatment-seeking prescription opioid drug addicts were put in the two-phase trial. The first phase started with two weeks of taking the drug Suboxone to stabilize, then tapered off for two weeks.
Eight weeks after the four-week treatment ended the patients were evaluated. If they were no longer abusing opioids, they discontinued the study.
If, after eight weeks, they were back to abusing opioids they entered phase two of the study. Phase two began with a 12-week Suboxone treatment, followed by a four-week taper. Again, after eight weeks the patients were evaluated for success or failure.
The participants were given opioid dependence counseling during both phases.
Phase one only produced a 7 percent success rate. Phase two produced a 49 percent success rate. The phase two success rate dropped significantly after the eight-week follow up down to 9 percent.
The study said chronic pain conditions did not affect outcomes, but previous heroin use lowered the likelihood of success during the trial. Symptoms of withdrawal from opioids were still a problem when the patients took Suboxone.
The authors concluded that the use of Suboxone to treat opioid dependence was successful even if success rates dropped significantly after treatment with Suboxone ended.
Dr. Weiss said, “[R]ecent data tells us that the use of prescription painkillers for nonmedical reasons is 20 times more common than use of heroin, and 50 percent more people seek treatment for prescription drug abuse than for heroin.”
Nora Volkow, MD, director of the National Institute on Drug Abuse, this study’s funding organization, said, “This study suggests that patients addicted to prescription opioid painkillers can be effectively treated in primary care settings using Suboxone.”
“However, once the medication was discontinued, patients had a high rate of relapse, so more research is needed to determine how to sustain recovery among patients addicted to opioid medications.”
This study was published in the Archives of General Psychiatry, December 2011. Funding for the study was provided by grants from the National Institute on Drug Abuse Clinical Trials Network, no conflicts of interest were found.