Multimodal drug addiction treatment: A field comparison of methadone and buprenorphine among heroin- and cocaine-dependent patients
Received 10 November 2005; received in revised form 16 February 2006; accepted 13 March 2006.
Abstract
Aims
Our objective was to compare the effectiveness of buprenorphine (BUP) and methadone maintenance treatment in opiate-addicted patients in a clinical nonexperimental setting.
Design
We used a naturalistic observational prospective study of 24 months' duration.
Setting
Subjects were enrolled and treated at a drug addiction outpatient clinic of the National Health System Local Unit in Milan, Italy.
Participants
Two hundred fifty-seven subjects meeting the DSM-IV criteria for opioid dependence and opioid-seeking substitutive pharmacological treatment participated in the study.
Intervention
One hundred twenty-one subjects received BUP at a mean daily dose of 11 ± 6 mg (median = 8; range = 2–30) for a mean duration of 249 days. One hundred thirty-six subjects received methadone at a mean daily dose of 54 ± 29 mg (median = 50; range = 4–140) for a mean duration of 267 days.
Measurements
The main efficacy parameters were treatment retention rates and illicit substance abuse, as assessed by urinalysis.
Findings
Retention rates were comparable in both treatment groups, but BUP-treated subjects had significantly lower rates of illicit opiate consumption (p < .0001).
Conclusions
The results confirm that, in a nonexperimental clinical practice setting, BUP is as effective as methadone in the treatment of heroin dependence, with significantly better opiate abuse control, thus possibly allowing longer and more effective treatment programs with reduced relapse rates.
ABSTRACT