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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
Statement of
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
RMID: 0020030731
DOI: 10.1046/j.1360-0443.2003.00335.x
Published version:
Appears in Collections:Pharmacology publications

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