Opioid withdrawal and its stabilization on sublingual buprenorphine in intravenous drug users: A South Gujarat Perspective
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Consultant Psychiatrist NMHP, DHS, Goa
Government Medical College, Surat, Gujarat
SMIMER Medical College and Hospital, Surat
Submission date: 2018-07-21
Final revision date: 2019-04-18
Acceptance date: 2019-05-09
Online publication date: 2020-03-21
Publication date: 2020-03-21
Corresponding author
Saumitra Shankar Nemlekar   

Consultant Psychiatrist NMHP, DHS, Goa
Arch Psych Psych 2020;22(1):63-69
Aim of the study:
Opioid Substitution Therapy involves replacing the client’s primary drug of use (opioid) with a medically safe drug or the same opioid in a safer mode of administration under medical supervision.

Subject or material and methods:
It is a prospective follow up study observing opioid withdrawal and its stabilization on buprenorphine sublingual tablets. Patients who fulfilled the criteria for Opioid substitution therapy by NACO guidelines were enrolled and given buprenorphine sublingual tablets; (0.2mg and 2mg). They were followed up on 1st to 3rd, 7th, 14 and 28th day for assessment for withdrawal and its resolution on buprenorphine. The withdrawal was assessed using Clinical Opioid Withdrawal Scale (COWS). Duration of study was 2 years.

Total 44 patients were enrolled. 37 IDU users completed the period of observation. They belonged to 19 to 52 years age group, the duration of use ranged from 2 – 32 years. patients’ had mild to moderate range of withdrawal. The mean score of COWS was 11.2 with a range of 5 – 24. Mean Buprenorphine dose requirement on 1st day was 6.19mg with range from 1.2 to 14 mg. Dose requirement at day 28 was in the range from 0.6 – 16mg.

There are many guidelines with fixed dose that are higher. We found lower dose requirements.

This study is empirical information on the issue of a reference dosage for buprenorphine regimen in an Indian Study population. However further research on such lines is required to suggest guidelines for Indian Population

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