Buprenorphine versus methadone maintenance for the treatment of opioid dependence (original) (raw)
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Buprenorphine: a controlled clinical trial in the treatment of opioid dependence
Drug and Alcohol …, 2000
Clinical trials carried out to compare methadone and buprenorphine in the treatment of opioid dependence have generally employed an alcoholic solution of buprenorphine, which has a bioavailability superior to that of the tablets. Since the product available for large scale use is in tablet form, one intended to verify the efficacy of this formulation.
Buprenorphine in the treatment of opioid dependence
European Neuropsychopharmacology, 2004
Buprenorphine has become of increasing interest to be an alternative to methadone in the treatment of heroin addicts. The aim of the paper is to review, from a clinical perspective, the current status of what is known about the pharmacology of buprenorphine, with a particular emphasis on the issues of maintenance therapy in heroin addiction. A systematic review of published follow-up data, from observational and experimental studies was done. Electronic databases Medline and PSYNDEXplus were searched from their earliest entries. Buprenorphine appears to be a well-tolerated drug, with a benign overall side effect. Buprenorphine is an additional treatment option for heroin dependent patients, especially for those who do not wish to start or continue with methadone or for those who do not seem to benefit from adequate dosages of methadone. D
Use of Buprenorphine in the Management of Opioid-Addicted Patients
Introduction: Dependence on opioid drugs is a major health and social issue in most societies. In the United States, it was estimated that there are at least 1 million opioid-dependent persons with heroin dependence costing $21 billion per year with drug treatment expenses accounting for 5.7 percent of the total cost (Jones, Moore, Sindelar, O'Conner, Schottnefeld, & Fiellin, 2009). Given these costs, an effective treatment for heroin dependence would be a good investment for society. Methods: This secondary data analysis is an evaluation of the Baltimore Buprenorphine Initiative. The sample consisted of subjects treated in the Baltimore Buprenorphine Initiative (BBI), and was evaluated against two comparison groups: patients receiving methadone treatment and a second a group of patients receiving intensive outpatient treatment. Descriptive statistics were used to describe the demographics of all three groups. Analysis of variance (ANOVA) was used to compare specific differences...
Clinical efficacy of buprenorphine: comparisons to methadone and placebo
Drug and Alcohol Dependence, 2003
Buprenorphine has been studied extensively since 1978 when it was initially proposed as an alternative to methadone for treatment of opioid dependence. Early work by Jasinski, Mello, Mendelson and their colleagues demonstrated buprenorphine's low physical abuse potential and its ability to substitute for heroin and reduce heroin self-administration in opiate-dependent humans. The subsequent early clinical studies suggested that, in clinical settings, buprenorphine was a safe and efficacious opiate dependence pharmacotherapy. Formal approval for general clinical use, however, required that systematic data be gathered on buprenorphine's safety and efficacy in larger groups and a series of controlled clinical trials was designed to evaluate its utility from a medication development perspective. In general, these trials adhered to one of three basic protocol designs: comparison of buprenorphine to methadone; dose comparisons using dose response as an indicator of efficacy; and comparison of buprenorphine to placebo. Retention in treatment, reduction in illicit drug use and craving, and patient and staff ratings of improvements were the most frequently used outcome indicators in these trials. Additional data collected included optimum dosing and dosage schedules, adverse reactions and common side-effects, and other information intended to clarify buprenorphine's benefit Á/risk relationship and to help prepare guidelines for its safe marketing and utilization by physicians in general clinical practice. This paper presents a review of the buprenorphine/methadone comparison trials conducted in the United States and two such trials conducted in Europe. Also reviewed are three placebo-controlled trials and a buprenorphine/methadone detoxification study. Overall, this series of studies did firmly establish the efficacy of buprenorphine alone and in comparison to methadone. #
Drug and Alcohol Dependence, 2003
Although only a partial m-opiate agonist, buprenorphine can be abused and diverted from medical therapy to the illicit drug market. A combination of buprenorphine and naloxone for sublingual administration may discourage diversion and abuse by precipitating opiate withdrawal when taken parenterally. Because opiate-abusing populations are not homogeneous and have varying levels of opiate dependence, the efficacy of buprenorphine and naloxone in precipitating opiate withdrawal or in attenuating the pleasurable effects of buprenorphine may vary. This chapter describes the effects of sublingual and parenteral buprenorphine and naloxone combinations in several populations of opiate-dependent people. We conclude that buprenorphine and naloxone combinations should not diminish the efficacy of sublingual buprenorphine, but should have lower abuse liability than buprenorphine alone. #