Transferring Methadone‐maintained Outpatients to the Buprenorphine Sublingual Tablet: A Preliminary Study

Abstract
There is no accepted algorithm to transfer opioid‐dependent patients from methadone (METH) to its new alternative, buprenorphine (BUP). Five outpatients transferred (double blind, double dummy) from METH 60 mg/day (with one day at 45 mg) to BUP 8 mg s.l. tablet. Relative to METH maintenance, BUP decreased opioid agonist symptoms (transfer day 1) and increased withdrawal symptoms (days 1 and 2) and blood pressure (day 2). Self‐reported heroin use did not increase from METH maintenance levels. It may be feasible to transfer outpatients on METH 60 mg/day to BUP 8 mg/day s.l. tablet, although this pilot protocol needs refinements to improve tolerability and clinical efficacy.