In a comparison of two drugs prescribed to treat teenagers dependent on heroin and other opioids, the drug buprenorphine was more effective, especially in treatment retention, according to a study in the October issue of Archives of General Psychiatry.
The use of heroin among adolescents has more than doubled in the past ten years, and the use of prescription opiates, including controlled release oxycodone (OxyContin) and hydrocodone bitartrate and acetaminophen (Vicodin), has also increased, according to background information in the article. Opiates are the second most commonly abused class of illicit drugs among adolescents, second only to marijuana. Despite the need to identify effective treatments, virtually no research has been conducted to systematically characterize or evaluate treatment interventions for adolescent heroin and opioid abusers.
Lisa A. Marsch, Ph.D., and colleagues at the University of Vermont, Burlington, evaluated the relative efficacy of buprenorphine hydrochloride and another drug, clonidine hydrochloride, in detoxification of opioid-dependent teenagers. (Dr. Marsch is now with the National Development and Research Institutes and St. Luke's-Roosevelt Hospital Center, New York.) Buprenorphine hydrochloride treats opiate addiction by preventing symptoms of withdrawal from heroin and other opiates. Clonidine hydrochloride belongs to a class of drugs known as alpha-blockers. It is commonly prescribed to treat high blood pressure.
The researchers conducted a double-blind, randomized, controlled trial in an outpatient research clinic at the University of Vermont from October 2001 to December 2003. A volunteer sample of 36 opiate-dependent adolescents (aged 13-18) took part in the study. They were randomly assigned to a 28-day, outpatient, medication-assisted withdrawal treatment with either buprenorphine or clonidine. Both drugs were provided along with behavioral counseling three times a week, and incentives contingent on opiate abstinence.
"Results clearly demonstrated that combining buprenorphine with behavioral interventions is significantly more efficacious in the treatment of opioid-dependent adolescents relative to combining clonidine and behavioral interventions," the authors report.