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Objective: The current study aimed at comparison of retention rates for daily dispensing (DD) and alternate-day dispensing (AD) regimens for buprenorphine over a 1-year period at a tertiary care treatment center for management of substance use disorders. Additionally, it aimed at comparison of prescription refill proportions for these two buprenorphine dispensing regimens over a 1-year period., Setting: The study was conducted at a tertiary level substance use disorder treatment center., Patients, Participants: Case records of patients satisfying the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria for opioid dependence syndrome were included in the study., Main Outcome Measures: Retention rates and prescription refill proportions were compared for the two buprenorphine dispensing regimens for different time intervals over a 52-week period., Results: Fifty-two subjects (45.61 percent) were started on DD regimen and 62 (54.38 percent) were put on AD regimen of buprenorphine. All subjects were opioid dependent. The two groups did not differ for prescription refill proportions as well as retention rates for any of the time intervals studied., Conclusion: The findings of the current study support feasibility and acceptance of alternate-day dosing strategy for buprenorphine dispensing for patients with opioid dependence.

Aim/background: Tramadol is a synthetic opiate and a centrally acting weak m-opioid receptor agonist. The potential advantages of tramadol include ease of administration, low abuse potential, and being nonscheduled. This study compared tramadol and buprenorphine for controlling withdrawal symptoms in patients with opioid dependence syndrome., Methods: Consenting male subjects between 20 and 45 years of age who fulfilled the ICD-10-DCR criteria for opiate dependence syndrome were randomly assigned in a double-blind, double-dummy placebo-controlled trial for detoxification. Those with multiple drug dependence, abnormal cardiac, renal and hepatic functions, psychosis, or organic mental illness were excluded. Assessments included Subjective Opiate Withdrawal Scale (SOWS), Objective Opiate Withdrawal Scale (OOWS), Visual Analog Scale (VAS), and Side Effect Check List. Subjects were evaluated daily and study duration was 10 days., Results: Sixty two subjects were enrolled. The mean SOWS and OOWS and VAS were significantly lower in the buprenorphine group on second and third day of detoxification as compared to the tramadol group. Although the retention rate was higher for buprenorphine group throughout the study, when compared with tramadol the difference was not significant on any day. Three subjects in the tramadol group had seizures., Conclusions: Tramadol was found to have limited detoxification efficacy in moderate to severe opioid withdrawal and substantial risk of seizures as compared to buprenorphine. Further studies are warranted to examine its efficacy in mild opioid withdrawal symptoms and its potential use in outpatient settings where its administration advantages may be valuable.

Objective: In view of increasing safety concerns, there is a need to assess benefits of use of dextropropoxyphene as opioid substitution treatment, if any. This study aims at urinalysis-based comparative evaluation of pattern of use of dextropropoxyphene and buprenorphine among opioid-dependent subjects., Setting: Laboratory of a tertiary care drug-dependence treatment center., Participants: Patients on buprenorphine and dextropropoxyphene therapy and their urinalysis records., Interventions: Nonexperimental chart review method., Main Outcome Measure(s): "Use," "abuse, "and 'prescribed but not used rates" for buprenorphine and dextropropoxyphene were compared, using chi2-test with level of significance at p < 0.05., Results: Rate of "use" and "abuse" was significantly high for dextropropoxyphene. Rate of 'prescribed but not used" was significantly high for buprenorphine (p < 0.05)., Conclusions: Despite apparent benefits of dextropropoxyphene use in terms of better rates of "use" and 'prescribed but not used" as compared to buprenorphine, one needs to review the situation in light of recent reports of adverse effects with dextropropoxyphene and limited resources available.