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Methadone Treatment of Opiate Addiction: A Systematic Review of Comparative Studies
Shahid Ali1, Barira Tahir1, Shagufta Jabeen1
1Drs. Ali and Tahir are with the Smart Choice Treatment Center in Franklin, Tennessee. Ms. Malik is a Research Associate with the Smart Choice Treatment Center in Franklin, Tennessee. Dr. Jabeen is Site Director of the VA Residency Training Program in Nashville and Murfreesboro, Tennessee, and Site Director of the Geriatric Fellowship Program and Adjunct Associate Professor at Vanderbilt University, Nashville, Tennessee.
Abstract:
Opiate misuse is a chronic relapsing disease that has become an epidemic in the United States. Methadone is the mainstay of treatment for opiate addiction and has been researched widely. Recently, new avenues of treatment have been researched and developed. The objective of this review is to study methadone in comparison to other pharmacological options available or being considered for opiate addiction treatment through a methodical search and review of evidence provided by recent clinical trials conducted in this regard. There is a paucity of high quality randomized controlled trials focusing on the comparison between buprenorphine and methadone for treatment of opiate use disorder. Buprenorphine should be researched more for patient retention and satisfaction, as well as for its prospect for better outcomes in neonatal abstinence syndrome to generate more decisive recommendations. Current data suggest monitoring of liver enzymes with the use of buprenorphine/naloxone for better liver outcomes. In light of the analyzed data, the authors conclude that methadone should still be considered the preferred treatment mode in comparison to slow-release oral morphine and heroin.
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