Fast Effect of Buprenorphine on Opioid-dependent Patients with Suicidal Ideation: A Novel Approach

Background: Buprenorphine is usually administered tomanageopioid use disorderandpain syndromes. It could be a proper treatment option for suicidality, resistant depression, self-destructive behavior, and anxiety. Buprenorphine has a considerable abuse potential that confines its administration in patients committing suicide with a background of substance abuse. Objectives: The current study aimed to clarify the influence of different doses of buprenorphine on opioid-dependent patients committing suicide over a 2-day period in a randomized, clinical trial (RCT). Patients and Methods: Patients were randomly assigned into 3 groups. Twenty-three suicidal male patients whomet the DSM-5 (diagnostic and statistical manual of mental disorders) criteria for opioid dependence and sought treatment were recruited. Patients randomly received 32, 64, or 96 mg of buprenorphine as a single high-dose only and were hospitalized in a psychiatric inpatient ward. Out of the 23 patients, 9 (39.2%), 8 (34.8%), and 6 (26%) received 32, 64, and 96mgof buprenorphine, respectively. Psychometric assessment was performedusing the Beck scale for suicidal ideation (BSSI) and interview. All patients completed the 2-day treatment period. The results indicated a significant decrease in BSSI scores in each of the 3 groups (P < 0.05), but there was no difference in the outcome between the groups (P = 0.30). Conclusions: The current study results indicated that a single high-dose of buprenorphine could provide a speedy and safe means to treat suicidality in opioid-dependent patients.