The effect of sublingual
buprenorphine on cigarette smoking was examined in 23 adult men with DSM III-R diagnosis of concurrent
opiate and
cocaine dependence. After admission to a clinical research ward, subjects were detoxified with
methadone (10-50 mg/day), then were
drug-free for 6 days before random assignment to either 4 or 8 mg/day of
buprenorphine. Gradually increasing daily sublingual doses of
buprenorphine were administered for 5 days, then subjects were maintained on 4 or 8 mg/day of
buprenorphine for 12 days. Each subject's preferred brand of cigarettes was available ad libitum throughout the study. Five responses (FR 5) on a key were required to earn each cigarette. The time and number of cigarettes were recorded by an automated cigarette dispenser. Subjects acquired significantly more cigarettes during the
buprenorphine induction and maintenance phases (25.5+/-2.0) than during the
drug-free phase (18.5+/-1.8; p<0.0002). During
buprenorphine induction, the number of cigarettes acquired was positively correlated with increasing doses of
buprenorphine (p<0.001) and the inter-cigarette interval was significantly shorter during
buprenorphine maintenance than during
drug-free conditions (p<0.001). These data showed that daily administration of the partial mu
opioid agonist
buprenorphine was associated with increased smoking in men concurrently dependent on
opiates and
cocaine. These findings are consistent with previous reports of
opioid-cigarette interactions.