The Leeds Evaluation of Efficacy of Detoxification Study (LEEDS) prisons project pilot study: protocol for a randomised controlled trial comparing dihydrocodeine and buprenorphine for opiate detoxification

Abstract

Background: In the United Kingdom (UK), there is an extensive market for the class 'A' drug heroin. Many heroin users spend time in prison. People addicted to heroin often require prescribed medication when attempting to cease their drug use. The most commonly used detoxification agents in UK prisons are buprenorphine, dihydrocodeine and methadone. However, national guidelines do not state a detoxification drug of choice. Indeed, there is a paucity of research evaluating the most effective treatment for opiate detoxification in prisons. This study seeks to address the paucity by evaluating routinely used interventions amongst drug using prisoners within UK prisons.

The Leeds Evaluation of Efficacy of Detoxification Study (LEEDS) prisons project: a randomised controlled trial comparing dihydrocodeine and buprenorphine for opiate detoxification

“…It is important to state that the trial did not introduce any new intervention medications into HMP Leeds as dihydrocodeine and buprenorphine were the only detoxification agents available during the period of randomisation [ 20 ]. The trial took place for a year from summer 2004, which is important as during this period the first line agent for most UK prisons was dihydrocodeine, with buprenorphine slowly being introduced.…”

“…The only other controlled trial comparing agents for detoxification (methadone and lofexidine) in a UK prison randomised 74 prisoners [ 19 ]. However, the project team completed a detoxification trial in the homeless community comparing dihydrocodeine with buprenorphine [ 20 ]. From this, we estimated that with a sample size of 60 we would have a finding of clinical and statistical significance for differences in the primary outcome.…”

“…Whilst one British study evaluated the withdrawal severity of methadone versus lofexidine, the rates of completion were not sufficient to detect a statistically significant difference between the medications [ 19 ]. Given the dearth of randomised controlled trials for opiate detoxification in this environment, we felt it appropriate to introduce this methodology to answer an important research question which could inform clinical policy, decision making and prison policy directives [ 20 ]. This paper reports the findings of a trial comparing dihydrocodeine and buprenorphine for opiate detoxification in the UK prison setting.…”

Adoptive immunotherapy with interleukin-2 & induced killer cells in non-small cell lung cancer: A systematic review & meta-analysis

“…HR and CIs were calculated according to Cox proportional hazards modelling and a combined HR>1 suggested a higher risk of poor survival. The method by Tierney et al 14 was used to extract data when studies did not have direct information. Statistical heterogeneity assumption among studies was checked using the x 2 -based Q-test15.…”

The Leeds Evaluation of Efficacy of Detoxification Study (LEEDS) Prisons Project Study: protocol for a randomised controlled trial comparing methadone and buprenorphine for opiate detoxification

“…In 2004, the Leeds Evaluation of Efficacy of Detoxification Study (LEEDS) team conducted the first randomised controlled trial (RCT) comparing buprenorphine and dihydrocodeine for opiate detoxification in the community [ 13 , 14 ]. The research team then compared these two agents in a pilot trial in HMP (Her Majesty's Prison) Leeds [ 15 ], and recently submitted the results for publication. The LEEDS trial has since expanded to compare the open use of buprenorphine to methadone across healthcare in several prisons.…”