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PostPosted: Mon Jun 18, 2012 7:56 am 
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http://clinicaltrials.gov/ct2/show/NCT0 ... tex&rank=7

I was looking through www.clinicaltrials.gov today and came across this VERY interesting study. As most of you all know, we very often talk about how RB is convincing the medical community the subutex is more prone to abuse potential due to the lack of naloxone, the inactive ingredient in Suboxone. Well, apparently we aren't the only ones interested in this subject or theory, because this is a study on this very question sponsored by none other than Columbia University.

Quote:
Here's the study's stated purpose: The study is designed to compare the abuse liabilities of intravenous buprenorphine and buprenorphine/naloxone in individuals who are physically dependent on sublingual buprenorphine. We hypothesize that the abuse liability of buprenorphine/naloxone is lower than that of buprenorphine alone.

Partial description from study: We are proposing to evaluate the abuse potential of intravenous (IV) buprenorphine compared to IV buprenorphine/naloxone in buprenorphine-maintained injection drug users (IDUs), incorporating self-administration procedures with other measures of opioid effects. The proposed study will investigate the conditions that affect the self-administration of IV buprenorphine by buprenorphine abusers. The primary aim of the study is to compare the reinforcing effects of IV buprenorphine and IV buprenorphine/naloxone in IDUs maintained on different doses of sublingual buprenorphine (2, 8, and 24 mg/day). Secondary aims of the study are to compare the subjective, performance and physiological effects of IV buprenorphine and IV buprenorphine/naloxone.


We all have read how some people can IV bupe without suffering precipitated withdrawals. I don't know the details, but it has to do with what is in the person's system at the time. I think it's extremely interesting that a major university is actually looking at this abuse potential and not just taking RB's word for it, because obviously, the naloxone doesn't work as it's "supposed" or "designed" to.

Anyway, I thought it was extremely interesting that they did this. Oh and it appears that the Phase III trial ended in 2008. I'd love to find the results of the study. I'll set off to search for them and will post them if I find anything.

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PostPosted: Mon Jun 18, 2012 8:21 am 
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I found this about this study:

Quote:
A study by investigators at Columbia University that seems to have received inadequate attention appeared in 2002. Bottom line: “... results demonstrate that both [Subutex and Suboxone] served as re-inforcers … and that they may have similar [intravenous] abuse liability in recently detoxified individuals who abuse heroin.” (Comer and Collins. 2002. J Pharmac Exp Therap 303(2):695-703)


I also found the following:

http://www.immpact.org/meetings/Immpact ... /Comer.pdf (note the same name as above [Comer]).

And this blub:

http://buprenorphine.samhsa.gov/Bupreno ... 2.6.06.pdf

Quote:
A recent study that examined abuse of Subutex and Suboxone by untreated injection drug users found a strong preference for the formulation without naloxone. Three out of four respondents said their use was intended to self- medicate for addiction and/or to suppress withdrawal. Most (68%) had tried the Suboxone formulation, but a large majority (4 out of 5) said it produced a
“bad” experience (Alho, Sinclair et al., 2006).


And finally, here's what I found on the Columbia study: http://www.ncbi.nlm.nih.gov/pubmed/20403021

Quote:
Abuse liability of intravenous buprenorphine/naloxone and buprenorphine alone in buprenorphine-maintained intravenous heroin abusers.
Comer SD, Sullivan MA, Vosburg SK, Manubay J, Amass L, Cooper ZD, Saccone P, Kleber HD.
Source

Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY 10032, USA.

Addiction. 2010 Jul;105(7):1332.

Abstract

BACKGROUND:
Sublingual buprenorphine is an effective maintenance treatment for opioid dependence, yet intravenous buprenorphine misuse occurs. A buprenorphine/naloxone formulation was developed to mitigate this misuse risk. This randomized, double-blind, cross-over study was conducted to assess the intravenous abuse potential of buprenorphine/naloxone compared with buprenorphine in buprenorphine-maintained injection drug users (IDUs).

METHODS:
Intravenous heroin users (n = 12) lived in the hospital for 8-9 weeks and were maintained on each of three different sublingual buprenorphine doses (2 mg, 8 mg, 24 mg). Under each maintenance dose, participants completed laboratory sessions during which the reinforcing and subjective effects of intravenous placebo, naloxone, heroin and low and high doses of buprenorphine and buprenorphine/naloxone were examined. Every participant received each test dose under the three buprenorphine maintenance dose conditions.

RESULTS:
Intravenous buprenorphine/naloxone was self-administered less frequently than buprenorphine or heroin (P < 0.0005). Participants were most likely to self-administer drug intravenously when maintained on the lowest sublingual buprenorphine dose. Subjective ratings of 'drug liking' and 'desire to take the drug again' were lower for buprenorphine/naloxone than for buprenorphine or heroin (P = 0.0001). Participants reported that they would pay significantly less money for buprenorphine/naloxone than for buprenorphine or heroin (P < 0.05). Seven adverse events were reported; most were mild and transient.

CONCLUSIONS:
These data suggest that although the buprenorphine/naloxone combination has intravenous abuse potential, that potential is lower than it is for buprenorphine alone, particularly when participants received higher maintenance doses and lower buprenorphine/naloxone challenge doses. Buprenorphine/naloxone may be a reasonable option for managing the risk for buprenorphine misuse during opioid dependence treatment.


I would love to hear from those of you who have much more knowledge/experience with IV'ing bupe than I to hear your take on this. This conclusion is saying Subutex has more abuse potential than sub, due to not having the naloxone. Do you agree with this?

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-I'm only responsible for what I say, not for what you understand.


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PostPosted: Tue Jun 19, 2012 1:52 am 
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any day! i see some drug user's nock suboxone just because of this.

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PostPosted: Sun Jul 22, 2012 12:50 am 
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I'm an ideal candidate for this study.


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