Question

Which drug is used in the maintenance phase of opioid withdrawal?

• A. Buprenorphine
• B. Disulfiram
• C. Butorphanol
• D. Clonidine

Hint:

For opioid withdrawal, buprenorphine is commonly used for maintenance therapy due to its partial agonist activity on opioid receptors.

Answer 1

The Correct Option is A

Step 1: Separate the two phases of opioid treatment.
Detoxification handles the short-term, acutely uncomfortable withdrawal symptoms, whereas the maintenance phase is the long-term phase aimed at keeping the patient stable, blunting cravings, and preventing relapse. The question targets the maintenance drug.

Step 2: Match each drug to its role.
Maintenance is done with an agent that occupies the mu-opioid receptor in a controlled way. Buprenorphine, a partial mu-agonist (with kappa-antagonism), does exactly this: it relieves cravings and withdrawal, has a ceiling effect that limits respiratory depression and abuse potential, and is suitable for long-term substitution therapy (often combined with naloxone).

Step 3: Rule out the rest by mechanism.
Clonidine is an alpha-2 agonist that dampens autonomic withdrawal (sweating, tachycardia, anxiety) during detox only - it is not a maintenance agent. Butorphanol is a mixed agonist-antagonist used as an analgesic and can actually precipitate withdrawal, so it is not used for maintenance. Disulfiram belongs to alcohol-dependence treatment, acting via aldehyde dehydrogenase inhibition, and has no role in opioid care.

Conclusion: The long-term, anti-craving, partial-agonist substitution drug for opioid dependence is buprenorphine.

Final Answer: Option 1 - Buprenorphine.