Following are some of the relevant references to jusitify buprenorphine as a safe & effective Substitution therapy for treatment of opioid addiction.
The excerpts of NIDA trials :
National Institute On Drug Abuses’ (NIDA) - U.S.A exhaustive trials on Buprenorphine have established Buprenorphine as an ideal therapeutic Substitution therapy for Opioid Addiction.
All International studies amply suggest superior efficacy of Buprenorphine in the treatment of Opioid Drug Dependence.
“It would appear that Buprenorphine combines the desirable features of Naltrexone and Methadone in one medication. Because of its partial agonist properties at the m-receptor, buprenorphine will, like Methadone, be taken readily by recovering heroin addicts and will, like Naltrexone, antagonize the pharmacological effects of heroin.”
“Resnick (personal communication of March 18, 1992) has reported that at the ‘New York University Buprenorphine Treatment Program’,. “Buprenorphine treatment, in a general medical facility, is a acceptable and highly efficacious for many heroin addicts who refuse other treatment modalities. Further, Buprenorphine is effective over a wide range of doses (1.5 - 8 mg/day) in reducing craving for heroin and its use.” It would thus appear that Buprenorphine may be useful in treating heroin addicts who would refuse treatment with Methadone.
“NIDA is especially impressed with Buprenorphine`s low toxicity demonstrated in preclinical studies, and its safety, as judged from clinical experience to date, even at relatively high dose levels [Banks, 1979]. Buprenorphine has highly favorable therapeutic ratio due to the fact that it is a partial, rather than a full, agonist at the m- receptor [Lewis et al., 1983]. Respiratory depression, a major acute toxic effect of m agonist, is not a significant problem with Buprenorphine [Jasinski et al., 1978; Lukas st al., 1984]. Because of this, overdose problems with buprenorphine are likely to be less frequent [Mello and Mendelson 1980].”
“As an alternative to Methadone Maintainance Therapy, other oral opioid agents like Buprenorphine (Addnok) may increase patient choice and avoid some of the more unpleasant aspects of MMT.”
LANCET 1999 JAN 16; 353 (9148): 221-6
“Buprenorphine( addnok) is as effective as methadone in reducing heroin use, keeping patients in treatment, reducing HIV risk behavior & improving general psychological health & wellbeing.” -
THE NATIONAL DRUG & ALCOHOL RESEARCH CENTER (NDARC) trial at University of NSW
“The report findings support the safety & efficacy of 8 mg/day of Buprenorphine dose over a 16 week treatment & suggest that an adequate dose of buprenorphine will be a useful addition to pharmacotherapy.”
- RESEARCH REPORT , ( Walter Ling –Los Angels Addiction Treatment Center, Doralle Segal- US NIDA, Richard I.H. Wang –Medical College of veterans Affairs .)
“Currently agonist, antagonist & mixed compounds are available for relapse prevention in opiate dependent individuals. Results with adequate doses of agonist (methadone) are gratifying (60-70% are heroin free ). Tablet Buprenorphine (addnok) is a suitable alternative. The study concluded that 60% of patients on Buprenorphine (addnok) were free at 11 months. Antagonist treatment (Naltrexone ) has low acceptability , a high drop out rate & Expenses.”
PREVENTION OF RELAPSE –MEDICAL MODEL
(Dr. Rajat Ray – All India Institute of Medical Sciences, New Delhi, India )
RUSAN
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ADDNOK