Comparison of buprenorphine and methadone maintenance in opiate addicts

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H Eder1, G Fischer, W Gombas

  • 1Department of General Psychiatry, University Hospital of Psychiatry, Währinger Gürtel, Vienna, Austria. drogenambulanz@akh-wien.ac.at

European Addiction Research
|October 10, 1998
PubMed

Insights

Buprenorphine, an opioid dependency treatment, showed promise for drug abstinence but had lower retention rates than methadone. The 8 mg buprenorphine dose may have been too low for some patients.

Area of Science:

  • Pharmacology
  • Addiction Medicine
  • Clinical Research

Background:

  • Buprenorphine is a partial micro-opioid receptor agonist used for opioid dependency maintenance.
  • It offers potential advantages like lower dependence and milder withdrawal symptoms compared to full agonists.
  • Prior research suggested 8 mg sublingual buprenorphine efficacy comparable to 60 mg oral methadone.

Purpose of the Study:

  • To compare the efficacy of buprenorphine and methadone in treating opioid-dependent subjects.
  • To assess treatment retention and drug abstinence rates in patients receiving either buprenorphine or methadone.

Main Methods:

  • A 24-week European study involving 34 opioid-dependent subjects (16 buprenorphine, 18 methadone).
  • Free dosing schedule used, with a maximum buprenorphine dose of 8 mg and no upper limit for methadone.
  • Primary outcomes included drug abstinence (weekly urine analysis for opioids, cocaine, benzodiazepines) and treatment retention.

Main Results:

  • The buprenorphine group had a higher proportion of drug-negative urine samples, particularly for cocaine, though not statistically significant.
  • Treatment retention was significantly lower in the buprenorphine group compared to the methadone group.
  • The 8 mg buprenorphine dose limit may have influenced results, potentially being insufficient for highly dependent individuals.

Conclusions:

  • Buprenorphine demonstrates effectiveness in treating opioid dependency, particularly in more motivated individuals.
  • Further research is recommended to investigate buprenorphine's efficacy in specific patient subgroups.
  • The maximum 8 mg dose of buprenorphine may require adjustment for optimal outcomes in certain patient populations.

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