BUPRENORPHINE MAINTENANCE--DOSE SCHEDULE AND TX SETTING

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Because of the critical needs to develop alternatives to methadone for the maintenance treatment of opioid dependence and to expand the availability and accessibility of services in a cost-effective manner, we are proposing a 24-week randomized trial that will assess the clinical efficacy of alternative buprenorphine maintenance dosing strategies (daily versus thrice-weekly). The study conducted in a traditional maintenance program, compares daily buprenorphine maintenance dosing (Group 1) and thrice-weekly maintenance dosing (Group 2). To assess whether opioid dependent patients without major psychopathology or dependence on alcohol, sedatives or cocaine can benefit from less frequent dosing, subjects (N=90) will be required to meet stringent eligibility and exclusion criteria and will be stratified by gender and employment status prior to random assignment to treatment. Counseling conditions will be manual-guided and carefully supervised to insure adherence to the study protocol and the integrity of the treatment approaches. Major outcomes include retention in the clinical trial, reductions in illicit opioid and other drug use, and reductions in HIV risk behavior.