In the first clinical trial of a medication that was used for an extended time to treat opioid addiction in young adults, participants who received counseling and Suboxone (buprenorphine-naloxone) for 12 weeks had substantially better outcomes than those who received the standard treatment of short-term detoxification and counseling.
The study, published November 5 in the Journal of the American Medical Association, was conducted through the National Drug Abuse Treatment Clinical Trials Network supported by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health (NIH). Opioids include heroin, morphine and prescription pain killers such as Vicodin and Oxycontin.
Opioid-addicted youth who continued to take Suboxone for 12 weeks were less likely to use opioids, cocaine and marijuana, to inject drugs, or drop out of treatment than those who received short-term detoxification and counseling.
"These findings should reassure and encourage providers who have been hesitant to offer extended Suboxone treatment to this population," said NIDA Director Dr. Nora Volkow. "They also highlight the need for longer-term studies to determine whether sustained treatment can improve outcomes."
Suboxone is a medication containing buprenorphine and naloxone, combined in a single tablet. Buprenorphine - which has been used successfully as a treatment for heroin addiction - works by acting on the brain's opiate receptors to relieve withdrawal and cravings without prompting the same intense high or dangerous side effects as other opioids. When combined with naloxone, buprenorphine's abuse potential is further limited because people who try to inject it experience severe withdrawal symptoms. However, when Suboxone is taken orally, as prescribed, these adverse effects do not occur.
For this study, investigators recruited 154 opioid-addicted patients aged 15 to 21 at six outpatient substance abuse treatment clinics around the country. Patients had been addicted to opioids for an average of 1.5 years. All participants were offered group and individual counseling for 12 weeks. In addition, participants were randomly assigned to either 2 weeks of detoxification using Suboxone or 12 weeks of extended Suboxone treatment. In the latter group, the daily dose of Suboxone was gradually tapered downward starting at week 9 and the drug was discontinued at week 12.