A Comparison of the Efficacy of Buprenorphine and Clonidine in Detoxification of Heroin-Dependents and the Following Maintenance Treatment

BACKGROUND: This study compared the success rates of buprenorphine and clonidine in detoxification of heroin-dependents and evaluated the recurrence of drug abuse in patients taking naltrexone in a 6 month follow up. METHODS: A double-blind study was carried out in Kerman's psychiatric hospital on heroin-dependents seeking detoxification during the years 2007-2009.These patients were randomized into 2 groups receiving clonidine and buprenorphine. The success rate of detoxification was evaluated at the end of the trial and each patient was discharged with a daily consumption of 25 mg naltrexone. They were monitored for 6 months with respect to naltrexone consumption and withdrawal from drug abuse. FINDINGS: Overall 49 patients participated in the study. The success rate of detoxification with naltrexone was confirmed in all subjects. In the group receiving clonidine, 2 subjects (9.5%) had a clinical opiate withdrawal scale (COWS) above 12 in day 5 (P=0.186) and none of the subjects in the group taking buprenorphine had a COWS above 12 in day 5. The signs and symptoms of withdrawal and the desire for substance abuse was declined significantly in both groups over time; 19% of subjects detoxified with clonidine and 39% detoxified with buprenorphine continued taking naltrexone for one month and 52% detoxified with clonidine and 53.5% detoxified with buprenorphine entered the maintenance treatment. The average days remaining in treatment and being free of recurrence of drug abuse was not significantly different between the two groups in a 6 month follow-up. CONCLUSION: Administration of buprenorphine within a few days was more efficient in reducing the signs and symptoms of withdrawal when compared to clonidine. However, recurrence of drug abuse was not significantly different between the two groups.