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Heroin Addiction and Related Clinical Problems: 2005, 07, 3 (pages: 21 - 26)

Buprenorphine high-dose, broad spectrum, long-term treatment: A new clinical approach to opiate alkaloid dependency

Di Petta G., Leonardi C.

Summary: In a large but neglected district north of Naples, Italy, the Department for Dependencies has adopted a new treatment strategy: high-dose sublingual buprenorphine tablets for broad-spectrum, long-term use against opiate dependency. The trial is still in progress. 650 patients in the study from three U.O.SER.T. branches were included and received long-term treatment with buprenorphine. At present, 600 patients remain in treatment. The following parameters were investigated: overdose, morphine in the urine, side-effects, social and occupational reintegration, compliance with psychotherapeutic and rehabilitational treatments and reduction in the costs of hospitalization. The results show how compliance with broad-spectrum, high-dose, long-term buprenorphine treatment proves beneficial both from a clinical viewpoint and from a socio-economic one. The data suggest that: buprenorphine is not only indicated for patients with mild-to-moderate drug dependency; patients receiving buprenorphine <16 mg may be at risk of relapse into heroin use or to dropping out, with a consequent need for re-initiation of treatments; high-dose, long-term buprenorphine was remarkably effective in terms of reducing withdrawal and craving, and maintaining patients in lasting programmes of psychosocial rehabilitation; high-dose buprenorphine offers a new innovative treatment strategy in the integrated approach to opiate dependency.