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https://hdl.handle.net/2440/14266
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Type: | Journal article |
Title: | Buprenorphine versus methadone maintenance therapy: a randomized double-blind trial with 405 opioid-dependent patients |
Author: | Mattick, R. Ali, R. White, J. O'Brien, S. Wolk, S. Danz, C. |
Citation: | Addiction, 2003; 98(4):441-452 |
Publisher: | Carfax Publishing |
Issue Date: | 2003 |
ISSN: | 0965-2140 1360-0443 |
Statement of Responsibility: | Richard P. Mattick, Robert Ali, Jason M. White, Susannah O’Brien, Seija Wolk and Cath Danz |
Abstract: | AIMS: To assess the efficacy of buprenorphine compared with methadone maintenance therapy for opioid dependence in a large sample using a flexible dosing regime and the marketed buprenorphine tablet. DESIGN: Patients were randomized to receive buprenorphine or methadone over a 13-week treatment period in a double-blind, double-dummy trial. SETTING: Three methadone clinics in Australia. PARTICIPANTS: Four hundred and five opioid-dependent patients seeking treatment. INTERVENTION: Patients received buprenorphine or methadone as indicated clinically using a flexible dosage regime. During weeks 1–6, patients were dosed daily. From weeks 7–13, buprenorphine patients received double their week 6 dose on alternate days. MEASUREMENT: Retention in treatment, and illicit opioid use as determined by urinalysis. Self-reported drug use, psychological functioning, HIV-risk behaviour, general health and subjective ratings were secondary outcomes. FINDINGS: Intention-to-treat analyses revealed nO significant difference in completion rates at 13 weeks. Methadone was superior to buprenorphine in time to termination over the 13-week period (Wald c 2 = 4.371, df = 1,P = 0.037), but not separately for the single-day or alternate-day dosing phases. There were no significant between-group differences in morphine-positive urines, or in self reported heroin or other illicit drug use. The majority (85%) of the buprenorphine patients transferred to alternate-day dosing were maintained in alternate-day dosing. CONCLUSIONS: Buprenorphine did not differ from methadone in its ability to suppress heroin use, but retained approximately 10% fewer patients. This poorer retention was due possibly to too-slow induction onto buprenorphine. For the majority of patients, buprenorphine can be administered on alternate days. |
Keywords: | Buprenorphine methadone opioid dependence randomized trial treatment outcome. |
Description: | The definitive version is available at www.blackwell-synergy.com |
DOI: | 10.1046/j.1360-0443.2003.00335.x |
Published version: | http://www.blackwell-synergy.com/doi/abs/10.1046/j.1360-0443.2003.00335.x |
Appears in Collections: | Aurora harvest 2 Pharmacology publications |
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