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Heroin Addiction and Related Clinical Problems: 2005, 07, 1 (pages: 7 - 18)

Buprenorphine induction and stabilisation in the treatment of opiate dependence

Doran C., Holmes J., Ladewig D., Ling W.

Summary: Many early trials of buprenorphine in opiate dependence used fixed doses and slow induction protocols. However, more recent data show that subjects requiring higher doses need to be stabilised more rapidly. Analysis of ten trials suggests a relationship between days taken to reach a 6 mg buprenorphine tablet equivalent dose and retention of subjects at 4 weeks. Recent US studies show that dosage can be stepped up quickly, e.g. 8 mg on Day 1, 16 mg on Day 2. Maintenance dosage should then be adjusted to meet patients' clinical needs; fixed dose studies ignore the breadth of buprenorphine's effective dose range.