A Stepwise Strategy Utilizing Buprenorphine and Methadone

October 23, 2006 updated by: Karolinska University Hospital

Graded Strategy for Pharmacological Treatment of Heroin Dependence

The objective of this study is to compare optimally given methadone maintenance treatment (MMT) for heroin dependence with a novel, sequential strategy, where patients are offered buprenorphine as first line treatment, allowed dose adjustments as needed, and switched to methadone if the maximal dose of buprenorphine is insufficient.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The objective of this study is to compare optimally given methadone maintenance treatment (MMT) for heroin dependence with a novel, sequential strategy (STEP), where patients are offered buprenorphine as first line treatment, allowed dose adjustments as needed, and switched to methadone if the maximal dose of buprenorphine is insufficient.

For this purpose, 96 subjects at two centers (Uppsala and Stockholm) are randomized to MMT or STEP and followed for 6 months. Retention in treatment is the primary outcome. Secondary outcomes in completers are proportion urine samples free of illicit opiates on app. twice weekly sampling, and problem severity as measured by a semistructured interview, the Addiction Severity Index (ASI) at baseline and after 3 and 6 months.

Study Type

Interventional

Enrollment

96

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Sweden
      • Stockholm, Sweden, 14176
        • Dept of Clinical Neuroscience, Karolinska Inst

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

20 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Heroin dependence according to DSM IV > 1year
  • Age > 20 years
  • Acceptance of the stated treatment principles.

Exclusion Criteria:

  • Severe psychiatric illness such as dementia or psychosis compromising the patient's ability to provide informed consent
  • Other clinically significant psychiatric illness unless stable under treatment
  • Severe medical condition such as advanced lung disease, unstable cardiovascular disease, severe liver disease
  • Other clinically significant medical condition unless stable under treatment
  • Treatment with anti-seizure drugs or disulfiram
  • Pregnancy or intent to become pregnant within the next year
  • Ongoing nursing
  • Patients involuntarily discharged from a methadone or buprenorphine maintenance program within the last 3 months not eligible.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Retention in treatment

Secondary Outcome Measures

Outcome Measure
Proportion urine samples free of illicit drugs
Problem severity as measured by Addiction Severity Index

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Karolinska University Hospital

Collaborators

Schering-Plough
Region Stockholm
Swedish National Drug Policy Coordinator

Investigators

  • Principal Investigator: Markus Heilig, MD PhD, Karolinska Institute, Stockholm

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

August 1, 2005

Study Completion

March 1, 2006

Study Registration Dates

First Submitted

April 3, 2006

First Submitted That Met QC Criteria

April 3, 2006

First Posted (Estimate)

April 5, 2006

Study Record Updates

Last Update Posted (Estimate)

October 24, 2006

Last Update Submitted That Met QC Criteria

October 23, 2006

Last Verified

March 1, 2006

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • KarolinskaUH Regional 373/03

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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