fast effect of buprenorphine on opioid-dependent patients with suicidal ideation: a novel approach

Background: buprenorphine is usually administered to manage opioid use disorder and pain 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 who met 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 96 mg of buprenorphine, respectively. psychometric assessment was performed using 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.