Controlled opioid withdrawal evaluation during 72 h dose omission in buprenorphine-maintained patients

Thomas Eissenberg, Rolley E. Johnson, George E. Bigelow, Sharon L. Walsh, Ira A. Liebson, Eric C. Strain, Maxine L. Stitzer

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


Buprenorphine's clinical utility as an opioid dependence pharmacotherapy may be enhanced with less-than-daily dosing. This study assessed opioid withdrawal after an acute 72 h dose omission in buprenorphine-maintained patients (8 mg/day s.l.). Eight outpatients required to remain free of opioids, cocaine and benzodiazepines completed four double-blind, double-dummy, Latin-square ordered conditions. Test conditions of 8 or 16 mg s.l. buprenorphine were followed by 2 days of placebo dosing. Control conditions were buprenorphine maintenance (8 mg/day), to provide a reference for evaluation of placebo test days and naloxone administration (10 mg/70 kg i.m.) during 8 mg buprenorphine maintenance to assess withdrawal measure sensitivity. Subjective measures and pupil diameter were significantly influenced only by naloxone. The lack of subjective symptoms and physiological signs of opioid withdrawal during 72 h of acute dose omission supports the feasibility of less-than-daily dosing at buprenorphine doses of 8 mg/day in patients who have demonstrated an ability to remain drug-free for an extended period.

Original languageEnglish
Pages (from-to)81-91
Number of pages11
JournalDrug and Alcohol Dependence
Issue number1-2
StatePublished - Apr 14 1997

Bibliographical note

Funding Information:
The authors thank Robin Clay, Connie Lowery, and Diana Beasley for nursing assistance, Diane Poling for patient counseling, and Richard Hernandez for data management assistance. This research was supported by USPHS grants ROl-DA04011, T32-DA07209, K05-DA00050, and K20-DA0166. Buprenorphine concentrations were determined by the Center for Human Toxicology, University of Utah under NIDA contract no. NOlDA-1-9205.


  • Antagonist-precipitated withdrawal
  • Buprenorphine
  • Less-than-daily-dosing
  • Opioid antagonists
  • Physical dependence
  • Spontaneous withdrawal

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)


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