Abuse liability of intravenous buprenorphine/naloxone and buprenorphine alone in buprenorphine-maintained intravenous heroin abusers
Abuse liability of intravenous buprenorphine/naloxone and buprenorphine alone in buprenorphine-maintained intravenous heroin abusers
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DOI：
10.1111/j.1360-0443.2009.02843.x
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发表时间：
2010-04-01
期刊：
影响因子：
6
通讯作者：
Kleber, Herbert D.
中科院分区：
文献类型：
--
作者：
Comer, Sandra D.;Sullivan, Maria A.;Kleber, Herbert D.
研究背景舌下含服丁丙诺啡是阿片类药物依赖的有效维持治疗方法，但静脉注射丁丙诺啡时有误用。开发了丁丙诺啡/纳洛酮制剂以缓解这种误用风险。这种随机，双盲，交叉研究进行评估的丁丙诺啡/纳洛酮的静脉内滥用潜力相比，丁丙诺啡在丁丙诺啡维持注射吸毒者（IDUs）MethodsIntravenous海洛因用户（n = 12）住在医院8-9周，并保持在三个不同的舌下丁丙诺啡剂量（2毫克，8毫克，24毫克）。在每个维持剂量下，参与者完成了实验室检查，在此期间检查了静脉注射安慰剂、纳洛酮、海洛因和低剂量和高剂量丁丙诺啡以及丁丙诺啡/纳洛酮的强化和主观效应。每个参与者收到每个测试剂量下的三个丁丙诺啡维持剂量conditions.ResultsIntravenous丁丙诺啡/纳洛酮自我管理的频率低于丁丙诺啡或海洛因（P < 0.0005）。当维持最低舌下丁丙诺啡剂量时，参与者最有可能自行静脉给药。丁丙诺啡/纳洛酮的“药物喜好”和“再次服药欲望”的主观评分低于丁丙诺啡或海洛因（P = 0.0001）。受试者报告他们愿意为丁丙诺啡/纳洛酮支付的费用显著低于丁丙诺啡或海洛因（P < 0.05）。七个不良事件的报告，大多数是轻度和transient.ConclusionsThese数据表明，虽然丁丙诺啡/纳洛酮组合有静脉内滥用的潜力，这种潜力是低于它是单独丁丙诺啡，特别是当参与者接受较高的维持剂量和较低的丁丙诺啡/纳洛酮挑战剂量。丁丙诺啡/纳洛酮可能是阿片类药物依赖治疗期间管理丁丙诺啡滥用风险的合理选择。
BackgroundSublingual buprenorphine is an effective maintenance treatment for opioid dependence, yet intravenous buprenorphine misuse occurs. A buprenorphine/naloxone formulation was developed to mitigate this misuse risk. This randomized, double-blind, cross-over study was conducted to assess the intravenous abuse potential of buprenorphine/naloxone compared with buprenorphine in buprenorphine-maintained injection drug users (IDUs).MethodsIntravenous heroin users (n = 12) lived in the hospital for 8-9 weeks and were maintained on each of three different sublingual buprenorphine doses (2 mg, 8 mg, 24 mg). Under each maintenance dose, participants completed laboratory sessions during which the reinforcing and subjective effects of intravenous placebo, naloxone, heroin and low and high doses of buprenorphine and buprenorphine/naloxone were examined. Every participant received each test dose under the three buprenorphine maintenance dose conditions.ResultsIntravenous buprenorphine/naloxone was self-administered less frequently than buprenorphine or heroin (P < 0.0005). Participants were most likely to self-administer drug intravenously when maintained on the lowest sublingual buprenorphine dose. Subjective ratings of 'drug liking' and 'desire to take the drug again' were lower for buprenorphine/naloxone than for buprenorphine or heroin (P = 0.0001). Participants reported that they would pay significantly less money for buprenorphine/naloxone than for buprenorphine or heroin (P < 0.05). Seven adverse events were reported; most were mild and transient.ConclusionsThese data suggest that although the buprenorphine/naloxone combination has intravenous abuse potential, that potential is lower than it is for buprenorphine alone, particularly when participants received higher maintenance doses and lower buprenorphine/naloxone challenge doses. Buprenorphine/naloxone may be a reasonable option for managing the risk for buprenorphine misuse during opioid dependence treatment.