Buprenorphine may be more effective than clonidine and other symptomatic medications for short term ambulatory heroin withdrawal.

Main results The buprenorphine group had better treatment retention than controls at day 8 and day 35 (see table). The buprenorphine group also reported fewer days’ heroin use during withdrawal (3 v 5 days control) and in the post-withdrawal period (9 v 15 days control). No severe adverse events were reported. Conclusions Buprenorphine is safe and effective for short-term ambulatory heroin withdrawal. Compared to clonidine and other symptomatic medications, buprenorphine was associated with greater retention, less heroin use and less discomfort during withdrawal.