The development and application of a rapid gas chromatography-mass spectrometry method to monitor buprenorphine withdrawal protocols

There are several drug therapies that can be used to treat opiate abuse. One such treatment that is currently gaining wide acceptance is the use of the combined agonist/antagonist drug buprenorphine. As with all long-term treatments, there is a potential for compliance issues to arise, which establishes the need for a technique to facilitate the monitoring of individuals prescribed buprenorphine. One such method has been developed and applied to the routine monitoring of buprenorphine and its primary metabolite in urine. The method was found to be sensitive (limits of detection of 1.0 ng/mL for both buprenorphine and norbuprenorphine), reproducible and linear up to 2000 ng/mL. This article describes the application of this method to the analysis of specimens collected from subjects prescribed a reducing low-dose buprenorphine regimen (10.0-0.4 mg per day) for acute opiate detoxification. A significant relationship between the daily dose and the mean creatinine-corrected concentration of buprenorphine in the urine was observed, together with a relatively stable relationship between the ratio of the urinary concentrations of norbuprenorphine to buprenorphine across the dose range studied.