Is there enough naloxone to deter the diversion? Effect of concurrent administration of intravenous naloxone on opioid agonist effects of intravenous buprenorphine: A randomised, double-blind, within-subject, crossover study among opioid-dependent subjects.
Drug Alcohol Rev
; 39(5): 595-603, 2020 07.
Article
en En
| MEDLINE
| ID: mdl-32162420
ABSTRACT
INTRODUCTION AND AIMS:
We aimed to evaluate and compare the effect of different intravenous doses of naloxone on reinforcing effect of intravenous buprenorphine (2 mg) in patients stabilised on sublingual buprenorphine. DESIGN ANDMETHODS:
This is a double-blind, within-subject, randomised, crossover study. Opioid-dependent patients, with history of intravenous drug use, stabilised on buprenorphine maintenance treatment were included after informed consent (n = 14). We administered and assessed the reinforcing effects of six test conditions buprenorphine and naloxone co-formulation (BNX) in 41, 21 and 11 dose ratio (i.e. buprenorphine 2 mg + naloxone 0.5, 1 and 2 mg, respectively), buprenorphine alone (2 mg), pheniramine maleate (45.5 mg) and saline at 24 hourly intervals.RESULTS:
No significant opioid withdrawals were precipitated during any test conditions. Compared to buprenorphine alone, 41 BNX had comparable euphoria, drug recognition, subjective opiate sensations and drug liking (P > 0.05); 21 BNX condition had significantly different subjective euphoria (P = 0.001), opioid recognition (P = 0.002), subjective opioid sensations at 60 min (P = 0.027) and drug liking (P < 0.001), while 11 BNX had significantly different objective euphoria (P = 0.002), opioid recognition (P = 0.030), subjective opioid sensations (P < 0.001) and drug liking (P < 0.001). No significant difference was noted on sedation scores between buprenorphine alone and all three combinations of BNX. DISCUSSION ANDCONCLUSIONS:
The 41 BNX condition did not impact the reinforcing agonist effects of buprenorphine. None of the intravenous BNX combination ratios precipitated opioid withdrawals. Findings emphasise the need for exploring more abuse deterrent mechanisms.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Buprenorfina
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Analgésicos Opioides
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Naloxona
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Antagonistas de Narcóticos
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Trastornos Relacionados con Opioides
Tipo de estudio:
Clinical_trials
Límite:
Adolescent
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Adult
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Drug Alcohol Rev
Asunto de la revista:
TRANSTORNOS RELACIONADOS COM SUBSTANCIAS
Año:
2020
Tipo del documento:
Article
País de afiliación:
India