Abstract
Buprenorphine has been proposed as a valuable substitution agent and a possible alternative to methadone for the treatment of opiate addicts because it has been shown to have a safer profile (less respiratory depression and sedation) and weaker withdrawal symptoms following abrupt discontinuation. Subsequently to the seminal report by Jasinski et al. (1), many studies have been conducted to assess the possible use of buprenorphine to treat opiate-dependent subjects. Buprenorphine given sublingually to opiate-addicted subjects actually showed satisfactory clinical efficacy when compared to placebo (2), impure placebo (i.e., low-dosage buprenorphine) (3),and methadone (4–6). However, the demonstration of buprenorphine’s efficacy and safety also questions the legitimacy of the stringent regulations usually restricting opiate substitution treatments to a limited number of authorized centers. For 5 yr, French authorities have been the first in the world to decide to relax buprenorphine’s legal control and to allow any physician and any community pharmacist to prescribe/deliver it to opiate-addicted patients.
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