A controlled trial of buprenorphine treatment for opioid dependence.
OBJECTIVE
To assess the efficacy of buprenorphine for short-term maintenance/detoxification.


METHODS
A randomized, double-blind, parallel group study comparing buprenorphine, 8 mg/d, methadone, 60 mg/d, and methadone, 20 mg/d, in a 17-week maintenance phase followed by an 8-week detoxification phase.


METHODS
Outpatient facilities at the Addiction Research Center, Baltimore, Md.


METHODS
One hundred sixty-two volunteers seeking treatment for opioid dependence.


METHODS
In addition to the medication, counseling using a relapse prevention model was offered but not required.


METHODS
Retention time in treatment, urine samples negative for opioids, and failure to maintain abstinence.


RESULTS
Throughout the maintenance phase, retention rates were significantly greater for buprenorphine (42%) than for methadone, 20 mg/d (20%, P less than .04); the percentage of urine samples negative for opioids was significantly greater for buprenorphine (53%, P less than .001) and methadone, 60 mg/d (44%, P less than .04), than for methadone, 20 mg/d (29%). Failure to maintain abstinence during the maintenance phase was significantly greater for methadone, 20 mg/d, than for buprenorphine (P less than .03). During the detoxification phase, no differences were observed between groups with respect to urine samples negative for opioids. For the entire 25 weeks, retention rates for buprenorphine (30%, P less than .01) and methadone, 60 mg/d (20%, P less than .05), were significantly greater than for methadone, 20 mg/d (6%). All treatments were well tolerated, with similar profiles of self-reported adverse effects. The percentages of patients who received counseling did not differ between groups.


CONCLUSIONS
Buprenorphine was as effective as methadone, 60 mg/d, and both were superior to methadone, 20 mg/d, in reducing illicit opioid use and maintaining patients in treatment for 25 weeks.
Johnson
R E
RE
Addiction Research Center, National Institute on Drug Abuse, Baltimore, Md.
Jaffe
J H
JH
Fudala
P J
PJ
D000328:Adult; D002047:Buprenorphine / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D003932:Heroin / Q000652:urine; D006556:Heroin Dependence / Q000534:rehabilitation / Q000652:urine; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D009294:Narcotics / Q000652:urine; D009293:Opioid-Related Disorders / Q000534:rehabilitation* / Q000652:urine; D016016:Proportional Hazards Models
D009294:Narcotics; D002047:Buprenorphine; D003932:Heroin; D008691:Methadone