Sigmon Stacey C, Dunn Kelly E, Badger Gary J, Heil Sarah H, Higgins Stephen T
Department of Psychiatry, University of Vermont, United States.
Addict Behav. 2009 Mar;34(3):304-11. doi: 10.1016/j.addbeh.2008.11.017. Epub 2008 Nov 24.
We examined the feasibility of brief outpatient detoxification as a treatment for prescription opioid (PO) abusers. Fifteen PO-dependent adults were enrolled to receive buprenorphine stabilization, a 2-week buprenorphine taper, and subsequent naltrexone for those who completed the taper. Subjects also received behavioral therapy, urinalysis monitoring, and double-blind drug administration. Subjects provided 83.8%, 91.7% and 31.2% opioid-negative samples during stabilization, taper and naltrexone phases, respectively. Inspection of individual subject data revealed systematic differences in whether subjects successfully completed the taper without resumption of illicit opioid use. Post-hoc analyses were used to examine the characteristics of subjects who successfully completed the taper (Responders, n=5) vs. those who failed to do so (Nonresponders, n=9). These pilot data suggest a subset of PO abusers may respond to brief buprenorphine detoxification, though future efforts should aim to improve outcomes, investigate individual differences in treatment response and identify characteristics that may predict those for whom longer-term agonist treatment is warranted.
我们研究了门诊短期戒毒作为处方阿片类药物（PO）滥用者治疗方法的可行性。招募了15名对PO药物依赖的成年人，先接受丁丙诺啡稳定治疗，然后进行为期2周的丁丙诺啡减量治疗，对于完成减量治疗的人随后给予纳曲酮治疗。受试者还接受行为疗法、尿液分析监测和双盲药物给药。在稳定治疗期、减量治疗期和纳曲酮治疗期，受试者分别有83.8%、91.7%和31.2%的样本检测为阿片类药物阴性。对个体受试者数据的检查显示，在受试者是否成功完成减量治疗且未恢复非法阿片类药物使用方面存在系统性差异。事后分析用于检验成功完成减量治疗的受试者（反应者，n = 5）与未成功完成的受试者（无反应者，n = 9）的特征。这些初步数据表明，一部分PO滥用者可能对短期丁丙诺啡戒毒有反应，不过未来的努力应旨在改善治疗结果、研究治疗反应的个体差异，并确定可能预测哪些人需要长期激动剂治疗的特征。
