Buprenorphine Suppresses Heroin Use by Heroin Addicts

TLDR

In a double‑blind study, heroin‑dependent men received buprenorphine or placebo while having access to 21–40.5 mg/day of intravenous heroin on a clinical research ward. Buprenorphine markedly reduced heroin self‑administration (up to 98 % at 8 mg/day), produced no withdrawal upon discontinuation, and was preferred over methadone or naltrexone, indicating it is a safe and effective treatment for heroin dependence.

Abstract

Heroin-dependent men were given buprenorphine (a partial opiate agonist-antagonist) or a placebo under double-blind conditions on a clinical research ward where they could acquire heroin (21 to 40.5 milligrams per day, intravenously). Buprenorphine significantly (P < .001) suppressed the self-administration of heroin over 10 days. Control subjects took between 93 and 100 percent of the available heroin. The effects of buprenorphine were dose-dependent; a dose of 8 milligrams per day reduced heroin use by 69 to 98 percent; a dose of 4 milligrams per day reduced heroin use by 45 percent. Termination of buprenorphine maintenance did not result in opiate withdrawal signs or symptoms. The subjects liked buprenorphine and indicated that it was preferable to methadone or naltrexone. Buprenorphine should be a safe and effective new pharmacotherapy for heroin dependence.