Buprenorphine versus methadone maintenance therapy: a randomized double‐blind trial with 405 opioid‐dependent patients

Mattick, Richard P.; Ali, Robert; White, Jason M.; O’Brien, Susannah; Wolk, Seija; Danz, Cath

doi:10.1046/j.1360-0443.2003.00335.x

Cited by 256 publications

(195 citation statements)

References 27 publications

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“…A recent large double-blind randomized controlled trial found that only 52% of methadone subjects were retained after 13 weeks (Mattick et al, 2003). Metaanalyses of psychotherapy studies that exclude those purely with substance abuse have found average dropout rates of about 50% across the treatment outcome literature (Wierzbicki & Pekarik, 1993).…”

Section: Discussionmentioning

confidence: 99%

A Preliminary trial of twelve-step facilitation and acceptance and commitment therapy with polysubstance-abusing methadone-maintained opiate addicts

et al. 2004

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Section: Discussionmentioning

confidence: 99%

A Preliminary trial of twelve-step facilitation and acceptance and commitment therapy with polysubstance-abusing methadone-maintained opiate addicts

et al. 2004

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“…Studies of the effi cacy of buprenorphine and methadone give inconsistent results, depending on various factors, such as dose height and application fl exibility [15,16,21] Also, the age, sex, length of heroin using, the severity of the symptoms of dependence, have an impact on the eff ectiveness of treatment by one or the other drug, so there are diff erent recommendations for the "fi rst line" in the treatment. Th e higher market price of buprenorphine restricts its widespread use compared to methadone.…”

Section: Discussionmentioning

confidence: 99%

“…It is characterized by a slow increase in maximal blood concentrations (4 hours), long half-life (25 hours), which supports its therapeutic efficacy, but also the cumulative eff ect aft er repeated dose and increased tolerance, indicating its addictive potential. Numerous of clinical studies [15,16] have shown its eff ectiveness, both on the underlying clinical symptoms of addiction, and on social and health implications, such as reducing the risk for HIV, reducing the addiction-related crime. Th e eff ectiveness of methadone therapy in terms of treatment retention and recidivism varies from study to study [16], from 20% to 70%, with a number of factors being aff ected as a genetic variability, specifi c metabolic characteristics, other medication, the use of other psychoactive substances, etc.…”

Section: Discussionmentioning

confidence: 99%

Recidivism with opiate addicted patients on buprenorphine substitution treatment: Case report

Crnic¹,

Todorovic²

2017

Hosp Pharm Int Multi J

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SUMMARYIntroduction: Opiate dependence is a serious, chronic and recurrent psychiatric disorder, whose prevalence reach epidemic proportions. This also contributes to a signifi cant increase in mortality, associated with overdose with opiates, as well as the rise in other health and social problems of the society. The methods and availability of treatment do not correspond to increased treatment needs, and treatment success is limited by the characteristics of the disorder, or numerous risk factors, which contribute to a high percentage of recidivism. Good clinical practice guidelines have defi ned treatment recommendations that include high and low-demanding programs. The personalized and integrative approaches are emphasized. Case report: The patient aged 41 years, intravenous-use opiate addict from his adolescences, with numerous psychological, health and social complications of addiction, is a participant in institutional treatment, following a court order as a measure of obligatory treatment, due to criminal off enses related to addiction. The history of the disease refers to numerous unsuccessful attempts to heal and short-term abstinence in the past, mainly in penal institutions. The patient meets all the criteria defi ned by the guidelines for inclusion in the buprenorphine maintenance program started in the year 2013. During the four-year treatment, the doses of the drug were adapted as needed; two heroin relapses and many in-risk situations for relapse were registered. The treatment continuated with close monitoring of the patient's condition and, with appropriate psychosocial interventions, contribute to keeping the patient in treatment and preventing the development of new complications of addiction, as well an improving the quality of his life. Discussion: Pharmacological treatment of opioid dependence relies on agents belonging to groups of antagonists, agonists and partial agonists of opiate receptors. The earlier programs with abstinence as a treatment goal have signifi cantly allocated the place to "harm reduction" programs, where the therapeutic goals are less demanding and defi ned as the harm-reduction of opiate dependence on the individual and the society. Treatment guidelines defi ne the principles and types of treatment regimens with agonists and partial agonists of opiate receptors and most commonly used are methadone and buprenorphine. The high risk of relapses despite treatment is defi ned and a comprehensive approaches and inclusion of Cognitive Behavior Therapy /CBT/, family and social therapy are needed.

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“…La buprénorphine à haut dosage est apparue sur le marché vers le milieu des années 1990 et constitue une autre approche pharmacologique dont l'efficacité est comparable à celle de la méthadone (Kakko & al., 2007 ;Giacomuzzi & al., 2003 ;Mattick & al., 2003 ;Schottenfeld & al., 2005). La réten-tion est cependant légèrement supérieure avec la méthadone.…”

Section: Palabras Clave: Metadona Buprenorfina Dependencia a Los Opunclassified

Les effets indésirables des médicaments de substitution dans le traitement de la dépendance aux opioïdes

Lauzon

2012

dss

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Le traitement de substitution, principalement avec la méthadone ou la buprénorphine, représente le traitement le plus efficace de la dépendance des opioïdes. Ces médicaments doivent, la plupart du temps, être pris pendant des périodes prolongées, soit plusieurs années ou toute la vie pour certains. Ces médicaments peuvent avoir des effets indésirables, ayant un impact sur la qualité de vie des patients, et nécessitent une attention de la part des professionnels de la santé impliqués dans le traitement. Seront révisés les effets indésirables suivants : hypogonadisme masculin, allongement du QT, sevrage néonatal, anomalies des fonctions respiratoires, hyperalgésie, risque d’intoxication, abus de la médication, interactions médicamenteuses. À ces effets pharmacologiques viennent s’ajouter des contraintes réglementaires, qui, si elles peuvent être pertinentes en début de traitement, s’avèrent lourdes et inadaptées pour les patients stables depuis plusieurs années. De l’écoute et une bonne gestion de ces effets indésirables sont indispensables pour améliorer l’acceptabilité du traitement et son attrait pour les usagers.

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Buprenorphine versus methadone maintenance therapy: a randomized double‐blind trial with 405 opioid‐dependent patients

Cited by 256 publications

References 27 publications

A Preliminary trial of twelve-step facilitation and acceptance and commitment therapy with polysubstance-abusing methadone-maintained opiate addicts

A Preliminary trial of twelve-step facilitation and acceptance and commitment therapy with polysubstance-abusing methadone-maintained opiate addicts

Recidivism with opiate addicted patients on buprenorphine substitution treatment: Case report

Les effets indésirables des médicaments de substitution dans le traitement de la dépendance aux opioïdes

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