Opiate withdrawal syndrome in buprenorphine abusers admitted to  a rehabilitation center in Tunisia.

Ines Derbel, Asma Ghorbel, Férièle Messadi Akrout, Abdelmajid Zahaf.
1. Faculty of Pharmacy, University of Monastir, Tunisia
2. Hygiene Laboratory Hedi Chaker Hospital, South of Tunisia
3. Research Laboratory Toxicology and Environment RL12SP07
4. Tunisian Association for the Prevention of Drug Use

Abstract
Background: Illicit use of high dosage buprenorphine has been well documented in several countries, including Tunisia.

Objectives: The aim of this survey is to assess the buprenorphine withdrawal syndrome time course, and how it may be affected  by the population characteristics among subjects admitted to a rehabilitation center in Tunisia.

Methods:A prospective research has permitted study of the socio-demographic characteristics and assessment of buprenorphine withdrawal syndrome among 32 subjects admitted for buprenorphine dependence by using the clinical opiate withdrawal  scale. An ANOVA was conducted to examine the effect of different factors on the withdrawal scores.

Results: 32 subjects were included. Among them 30 were males, 27 had been injecting buprenorphine, 16 were poly-drug  abusers and 2 had a history of mental disorders. Buprenorphine withdrawal syndrome was of a mild intensity and had a delayed onset. Withdrawal mean scores varied between 0 and 9, and maximum values were reached at day 21. These scores varied  significantly over time (p<0,001). The sex v time interaction and the mode of consumption of buprenorphine had significant  effects on the withdrawal scores (p<0,001). The poly-drug consumption and the history of mental disorders did not have any  significant effect on the withdrawal scores.

Conclusion: This study has permitted description of buprenorphine withdrawal syndrome among patients going through a detoxification treatment at a rehabilitation center. Understanding this syndrome would help elaborate effective and suitable buprenorphine dependence management plans.

Keywords: Buprenorphine, dependence, withdrawal.