Four-Week Tapering Beneficial for Rx Opioid-Dependent
(HealthDay News) – For prescription opioid (PO)-dependent outpatients, response is better with a four-week than a two- or one-week tapering regimen plus naltrexone hydrochloride therapy, according to a study published online Oct. 23 in JAMA Psychiatry.
Stacey C. Sigmon, PhD, from the University of Vermont in Burlington, and colleagues conducted a 12-week trial in an outpatient research clinic in which 70 PO-dependent adults underwent brief stabilization with a combination of buprenorphine hydrochloride and naloxone hydrochloride dihydrate, and were then randomized to receive one-, two-, or four-week tapering regimens followed by naltrexone therapy. Participants visited the clinic daily during Phase 1 (weeks 1–5 after randomization), and three times per week during Phase 2 (weeks 6–12 after randomization).
The researchers found that at the end of Phase 1, opioid abstinence was significantly greater in the four-week condition than in the two-week or one-week conditions (63%, 29%, and 29% of participants abstinent, respectively). Abstinence was also significantly greater at the end of phase 2 in the four-week versus the two- and one-week conditions (50%, 16%, and 20%, respectively). There were significantly more treatment responders in the four-week condition (50%, 17%, and 21%, respectively).
"Results suggest that a meaningful subset of PO-dependent outpatients may respond positively to a four-week taper plus naltrexone maintenance intervention," the authors write.
One author disclosed financial ties to Titan Pharmaceuticals. The buprenorphine and matched placebo tables were provided by Reckitt Benckiser Pharmaceuticals.