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HMS Studies Painkiller Abuse

By Cynthia W. Shih, Contributing Writer

Harvard Medical School and McLean Hospital researchers recently found that patients addicted to prescription opiate drugs, or painkillers, may be more likely to succeed in treatment with the aid of the medication Suboxone.

Involving 653 treatment-seeking patients from 10 sites nationwide, this study is the first large-scale clinical trial to address the treatment of painkiller abuse.

In addition to standard medical treatment for opioid abuse, each patient in the trial received Suboxone, which consists of a combination of two medications which treat opioid addiction and counter drug dependency.

According to Roger D. Weiss, a professor of Psychiatry at Harvard Medical School and chief of the Division of Alcohol and Drug Abuse at McLean Hospital, roughly half of the patients benefited from Suboxone while on the medication.  However, the researchers found that patients would often relapse when taken off the medication.

“What we found was that [almost all of the people] who were tapered off the medication relapsed into opiate use,” said Weiss.

“What stood out was that people did less well than we thought they would,” said Weiss. “We thought they would have better outcomes after being tapered off the medication than they did.”

Other experts in the field did not find the results as surprising.

“We see the same phenomenon with methadone for heroin-addicted patients,” said Keith N. Humphreys, a professor of Psychiatry at Stanford University. “Substitution therapy with Suboxone and methadone often has to last for a year or more, and for some patients must be continued indefinitely.”

According to Weiss, the main limitation of the research is that it was a relatively short-term study. To remedy this, the researchers will conduct a long-term follow-up study of the same population for 3.5 years after study entry.

“I’m hoping that people will see how difficult it is to get off of [prescription opiate drugs] in case they’re thinking of abusing them, and also that people realize that medication can really help with longer term treatment,” said Weiss.

“This is ground breaking research which responds to a crying need,” said Humphreys. “We have an epidemic of painkiller abuse in the U.S. and to know that addiction to these drugs can be treated with Suboxone is a major advance.”

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Harvard Medical SchoolMedicine