Participants experienced long-term OST as a transition between illicit drug use and recovery. Recovery was seen as a process rather than a fixed goal, confirming that there is a need for services to negotiate individualized recovery goals, spanning harm minimization and abstinence-oriented treatment approaches.
This prospective patient-preference study examined the effectiveness in practice of methadone versus buprenorphine maintenance treatment and the beliefs of subjects regarding these drugs. A total of 361 opiate-dependent individuals (89% of those eligible, presenting for treatment over 2 years at a drug service in England) received rapid titration then flexible dosing with methadone or buprenorphine; 227 patients chose methadone (63%) and 134 buprenorphine (37%). Participants choosing methadone had more severe substance abuse and psychiatric and physical problems but were more likely to remain in treatment. Survival analysis indicated those prescribed methadone were over twice as likely to be retained (hazard ratio for retention was 2.08 and 95% confidence interval [CI] = 1.49-2.94 for methadone vs. buprenorphine), However, those retained on buprenorphine were more likely to suppress illicit opiate use (odds ratio = 2.136, 95% CI = 1.509-3.027, p < .001) and achieve detoxification. Buprenorphine may also recruit more individuals to treatment because 28% of those choosing buprenorphine (10% of the total sample) stated they would not have accessed treatment with methadone.
Aims: To assess substance users' beliefs and the sources of these beliefs regarding methadone and buprenorphine and to examine how they choose between them. Design: Forty-two opiate-dependent patients seeking treatment chose between open label buprenorphine or methadone maintenance treatment. Prior to treatment patients completed a semi-structured interview or a self-completed questionnaire. Findings: Beliefs were based primarily on their own or other users' experiences. All patients chose their treatment. There was little difference between those choosing MMT and BMT in terms of their beliefs about the drugs, although the BMT group viewed methadone more negatively and buprenorphine more positively than the MMT group. Those choosing MMT appeared to do so on the basis of familiarity whereas those choosing BMT appeared to be attracted by their beliefs that it would block heroin more effectively, reduce craving, give less intoxication and be easier to stop taking. Conclusions: Opiate users rapidly become well informed about a new treatment when it becomes available. They rely more on their own and other users' experience than the information given by agencies. Choices between treatments are based more on individual perceived requirements than different beliefs
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.