A Clinical Trial Comparing Tapering Doses of Buprenorphine With Steady Doses for Chronic Pain and Coexistent Opioid Addiction
Open accessAbstract
OBJECTIVES: Effective strategies are needed to manage individuals with chronic non-cancer pain and coexistent opioid addiction. This study compared opioid discontinuation and opioid replacement protocols. METHODS: We planned to enroll 60 individuals into an open-label trial who had been treated with opioids for chronic non-cancer pain, and who also had opioid addiction. Participants were randomly assigned to one of two 6-month treatment protocols of buprenorphine/naloxone sublingual tablets: 1) tapering doses for opioid weaning or "detoxification" (active comparator group) or 2) steady doses for opioid replacement (experimental group). They were followed monthly for the study outcomes: completion of the 6-month treatment protocol and self-reported pain control, physical functioning, alcohol consumption and illicit drug use. RESULTS: Enrollment was terminated after enrolling 12 participants because none of the 6 assigned to receive tapering doses could successfully complete the protocol (5 were given steady doses and 1 was admitted to an inpatient chemical dependency treatment program); whereas, of the 6 assigned to receive steady doses, 5 completed the protocol (1 withdrew). This difference between the 2 treatment conditions was significant (P = 0.015). Of the 10 participants who completed the 6 month follow-up, 8 reported improved pain control and physical functioning and 5 used alcohol and/or illicit drugs. CONCLUSIONS: We conclude that over 6 months, these participants with chronic pain and co-existent opioid addiction were more likely to adhere to an opioid replacement protocol than an opioid weaning protocol and that opioid replacement therapy with steady doses of buprenorphine/naloxone is associated with improved pain control and physical functioning.
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Treatment with steady doses of buprenorphine/naloxone for six months results in treatment retention superior to detoxification followed by abstinence in chronic pain patients with co-existent opioid addiction.
“According to Blondell and his associates, treatment with steady doses of buprenorphine/naloxone for 6 months results in treatment retention superior to detoxification followed by abstinence in chronic pain patients with a co-existent opioid addiction.13”
From A Preliminary Study Comparing Methadone and Buprenorphine in Patients with Chronic Pain and Coexistent Opioid Addiction (2013) · cites this paper as [13]
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- Authors
- Blondell, R. D., Ashrafioun, L., Dambra, C. M., Foschio, E. M., Zielinski, A. L., & Salcedo, D. M.
- Affiliations
- Erie County Medical Center (US)
- Corresponding author
- Blondell, Richard D.
- Venue
- Journal of Addiction Medicine
- Published
- 2010-09
- Volume
- 4
- Issue
- 3
- Pages
- 140-146
- ISSN
- 1932-0620 (ISSN-L)
- PMC
- PMC2931595
- OpenAlex
- W2052838856
- Cited by
- 59
- References
- 16
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 7 · 2023: 1 · 2022: 5 · 2021: 3 · 2020: 5 · 2019: 4 · 2018: 3 · 2017: 3 · 2016: 4 · 2015: 3 · 2014: 3 · 2013: 6 · 2012: 4
- FWCI
- 4.45
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Addiction Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (K23AA015616)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- buprenorphine/naloxone, opioid substitution therapy, opioid tapering, opioid weaning, chronic non-cancer pain, opioid use disorder, medication adherence, pain management, physical function, alcohol consumption, illicit drug use
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