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Buprenorphine Maintenance vs. Detoxification in Prescription Opioid Dependence

This study is not yet open for participant recruitment.
Study NCT00555425.   Last updated on June 11, 2008.   Information provided by National Institute on Drug Abuse (NIDA)

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Descriptive Information Fields
Brief Title  Buprenorphine Maintenance vs. Detoxification in Prescription Opioid Dependence
Official Title  Buprenorphine Maintenance vs. Detoxification in Prescription Opioid Dependence
Brief Summary

The aim of the study is to determine whether buprenorphine/naloxone maintenance versus detoxification using buprenorphine/naloxone, in prescription opioid dependent patients receiving primary care management and drug counseling in an office-based setting, leads to decreased illicit opioid use.

Detailed Description

Prescription opioid dependence is increasing and creates a significant public health burden, but office-based physicians lack evidence-based guidelines to decide between maintenance or detoxification treatment with buprenorphine/naloxone. The proposed study compares buprenorphine/naloxone maintenance (Mtn) vs. detoxification (Dtx) in a 18-week randomized clinical trail in a heterogeneous population of prescription opioid dependent patients (N=120) in a primary care clinic. Patients are randomized to Mtn or Dtx after a 2-week induction period. Mtn is designed to reflect usual care by primary care physicians and includes weekly drug counseling (DC) and referral to ancillary services. Dtx and Mtn will be identical for the first 4 weeks (stabilization) following randomization. In Mtn, buprenorphine/naloxone will continue unchanged for the remainder of the study. In Dtx, the dosage of buprenorphine/naloxone will be tapered to zero over the next 3 weeks, and patients will not receive additional buprenorphine/naloxone for the remainder of the study. Dtx patients will be offered thrice-weekly DC beginning during the taper and naltrexone will be offered 7 days following the last dose of Bup. The study will test the hypothesis that Mtn will lead to decreased illicit drug use and will demonstrate incremental cost-effectiveness compared to Dtx. Relevance to public health: The results of this study will help define the role of maintenance vs. detoxification with buprenorphine/naloxone in the care of prescription opioid dependent patients in primary care.

Study Phase Phase IV
Study Type  Interventional
Study Design  Treatment, Randomized, Open Label, Active Control, Parallel Assignment, Efficacy Study
Primary Outcome Measure  Illicit opioid use [ Time Frame: 18 weeks ] [ Designated as safety issue: No ]
Secondary Outcome Measure  Proportion of patients protectively transferred [ Time Frame: 18 weeks ] [ Designated as safety issue: No ]
Retention in treatment [ Time Frame: 18 weeks ] [ Designated as safety issue: No ]
Reduction in cocaine use [ Time Frame: 18 weeks ] [ Designated as safety issue: No ]
Reductions in HIV risk [ Time Frame: 18 weeks ] [ Designated as safety issue: No ]
Patient satisfaction [ Time Frame: 18 weeks ] [ Designated as safety issue: No ]
Health status [ Time Frame: 18 weeks ] [ Designated as safety issue: No ]
Utilization and costs of services [ Time Frame: 18 weeks ] [ Designated as safety issue: No ]
Condition  Opiate Dependence
Intervention  Behavioral: Behavioral: Buprenorphine/naloxone maintenance (Mtn)
Behavioral: Behavioral: Buprenorphine/naloxone detoxification (Dtx)
MEDLINE PMIDs
Links
Recruitment Information Fields
Recruitment Status  Not yet recruiting
Enrollment  120
Start Date  July 2008
Completion Date April 2012
Eligibility Criteria 

Inclusion Criteria:

  • opioid dependence

Exclusion Criteria:

  • current dependence on alcohol, cocaine, benzodiazepines or sedatives
  • current suicide or homicide risk
  • current psychotic disorder or untreated major depression
  • inability to read or understand English
  • life-threatening or unstable medical problems
Gender Both
Ages 18 Years to 65 Years
Accepts Healthy Volunteers No
Contacts ††
Contact: Declan T. Barry, PhD     203-781-4650 ext 268     declan.barry@yale.edu    
Location Countries  United States
Administrative Information Fields
NCT ID  NCT00555425
Organization ID 1R01DA020576-01A1
Secondary IDs ††
Study Sponsor  National Institute on Drug Abuse (NIDA)
Collaborators †† Yale University
Investigators 
Principal Investigator:     David A. Fiellin, MD     Yale University    
Information Provided By National Institute on Drug Abuse (NIDA)
Verification Date June 2008
First Received Date  November 6, 2007
Last Updated Date June 11, 2008

 †    Required WHO trial registration data element.
††   WHO trial registration data element that is required only if it exists.




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