Addressing the efficacy of dihydrocodeine versus methadone as an alternative maintenance treatment for opiate dependence: a randomized controlled trial

Robertson, J. Roy; Raab, Gillian M.; Bruce, Malcolm; McKenzie, James S.; Storkey, Helen; Salter, Amy

doi:10.1111/j.1360-0443.2006.01603.x

Cited by 47 publications

(50 citation statements)

References 19 publications

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“…A single RCT from the UK of dihydrocodeine (30 mg equivalent to 2.5 mg methadone) and methadone showed dihydrocodeine had a similar treatment retention rate to methadone. There was no difference in other measured outcomes, but there was a lot of switching in the dihydrocodeine group to methadone (Robertson et al, 2006) (Ib).…”

Section: (Iii)mentioning

confidence: 99%

BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP

Welch²,

et al. 2012

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The British Association for Psychopharmacology guidelines for the treatment of substance abuse, harmful use, addiction and comorbidity with psychiatric disorders primarily focus on their pharmacological management. They are based explicitly on the available evidence and presented as recommendations to aid clinical decision making for practitioners alongside a detailed review of the evidence. A consensus meeting, involving experts in the treatment of these disorders, reviewed key areas and considered the strength of the evidence and clinical implications. The guidelines were drawn up after feedback from participants. The guidelines primarily cover the pharmacological management of withdrawal, short-and long-term substitution, maintenance of abstinence and prevention of complications, where appropriate, for substance abuse or harmful use or addiction as well management in pregnancy, comorbidity with psychiatric disorders and in younger and older people. KeywordsSubstance misuse, addiction, guidelines, pharmacotherapy, comorbidity 1 Imperial College London, CNWL NHS Foundation Trust, London, UK 2 Gether NHS Foundation Trust, Gloucester, UK 3 Pennine Care NHS Foundation Trust, Ashton-under-Lyne, UKOther invited participants at the consensus meeting who contributed to the discussion and commented on the guidelines were Drummond C, Farrell M, Gilvarry E, Strang J. John, a user representative, read and commented on the written guidelines. Prof W van den Brink reviewed the written guidelines.

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Section: (Iii)mentioning

confidence: 99%

BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP

Welch²,

et al. 2012

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“…Adverse events have emerged, including local cutaneous complications after injection (Ho 2009) and fatal overdoses associated with concomitant benzodiazepine misuse (Tracqui 1998). Furthermore, dihydrocodeine, an oral opioid, is a viable alternative to methadone as maintenance treatment but it has not received much attention outside Europe (Robertson 2006). In an attempt to address this controversy, we will briefly discuss the pharmacology of buprenorphine, the benefits and drawbacks of prescribing it, the prevalence of its misuse and the drug's potential negative consequences.…”

Section: The Controversy In Buprenorphine Maintenancementioning

confidence: 99%

“…It would be desirable to increase patient choice by considering dihydrocodeine (Robertson 2006) but more studies are required to assess patients' preference for this treatment outside Europe.…”

Section: Tailored Prescriptionmentioning

confidence: 99%

“…Dihydrocodeine is much shorter acting than methadone because of its lower affinity of binding to the m-opioid receptor. It is a good alternative for patients who want to avoid meth adone, with its sedative effect, dangers of toxicity, and stigma and regulations surrounding prescription and dispensing (Robertson 2006). Common side-effects include constipation, giddiness, hypersensitivity, itching, flushing and other effects of blood vessel dilation.…”

Section: Dihydrocodeine: the Neglected Alternativementioning

confidence: 99%

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Buprenorphine prescription, misuse and service provision: a global perspective

Ho¹,

Chen²,

Broekman³

et al. 2009

Adv. psychiatr. treat

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SummaryBuprenorphine, a partial μ-opioid agonist and κ-opioid antagonist, is recommended as safe and effective maintenance treatment for opioid dependence. It offers the possibility of management in primary care settings. However, its prescription has led to diversion for illicit recreational use and resulted in medical complications and, rarely, fatal overdose in combination with other sedatives. The outcome of buprenorphine maintenance programmes varies from country to country and it is determined by the local therapeutic traditions, regulatory restrictions and existing service provision for opioid misusers. This article addresses the pharmacology of buprenorphine, the benefits and drawbacks of its prescription, service provision for opioid misuse around the world, policy recommendations, and prescribing training requirements.

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“…However, randomization requires patients' voluntary informed consent [12], and not all prisoners will be prepared for their PMT to be determined randomly rather than by doctor-patient preference.…”

mentioning

confidence: 99%

[Commentary] DATABASE LINKAGE: OUTSIDE REFLECTIONS ON HEALTH CARE INSIDE PRISONS

Bird

2009

Addiction

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Addressing the efficacy of dihydrocodeine versus methadone as an alternative maintenance treatment for opiate dependence: a randomized controlled trial

Abstract: These results, combined with existing clinical experience, provide evidence that dihydrocodeine is a viable alternative to methadone as a maintenance treatment for opiate dependence. Indirect comparisons with other studies show dihydrocodeine (and methadone) to be superior to placebo.

Cited by 47 publications

References 19 publications

BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP

BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP

Buprenorphine prescription, misuse and service provision: a global perspective

[Commentary] DATABASE LINKAGE: OUTSIDE REFLECTIONS ON HEALTH CARE INSIDE PRISONS

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