Buprenorphine for the management of opioid withdrawal

Abstract

Editorial group: Cochrane Drugs and Alcohol Group. Publication status and date: New search for studies and content updated (conclusions changed), published in Issue 3, 2009.

The ibogaine medical subculture

“…It appears unlikely that suggestion or placebo could solely mediate the effect attributed to ibogaine in acute opioid withdrawal. Recent Cochrane reviews on the management of acute opioid withdrawal with ␣ 2 -agonists (Gowing et al, 2004), buprenorphine (Gowing et al, 2006) or methadone taper (Amato et al, 2005) evaluated a combined total of 56 studies. Overall rates of treatment completion among studies of ␣ 2 -agonists, buprenorphine, or methadone, respectively ranged from 48 to 64%.…”

The effects of buprenorphine on fentanyl withdrawal in rats

“…Buprenorphine ameliorates withdrawal from opioids such as heroin and decreases the likelihood of relapse to drugseeking behavior after a period of abstinence (Gowing et al 2004;Lintzeris et al 2003;Mattick et al 2004). In addition, buprenorphine has been shown to decrease the selfadministration of heroin in opioid-dependent humans, nonhuman primates, and rats (Chen et al 2006;Mello et al 1983;Mello and Mendelson 1980).…”

Anxiolytic-like effects of morphine and buprenorphine in the rat model of fear-potentiated startle: tolerance, cross-tolerance, and blockade by naloxone

“…Interestingly, buprenorphine has been shown to block the acquisition of opioid-withdrawal-induced conditioned place aversion in rats (Stinus et al 2005). Furthermore, buprenorphine is showing promise for the treatment of anxiety-related and other adverse behaviors associated with the withdrawal syndrome (Gowing et al 2002;Bailey 2004) and may also hold promise for the treatment of a population of patients refractory to conventional anxiolytics (Bodkin et al 1995). Improving our understanding of the behavioral pharmacology of buprenorphine's anxiolyticlike actions could advance the clinical success of this drug.…”