title: Multimodal drug addiction treatment: a field comparison of methadone and buprenorphine among heroin- and cocaine-dependent patients.
abstract: OBJECTIVE
  Our objective was to compare the effectiveness of buprenorphine (BUP) and methadone maintenance treatment in opiate-addicted patients in a clinical nonexperimental setting.
  
  
  METHODS
  We used a naturalistic observational prospective study of 24 months' duration.
  
  
  METHODS
  Subjects were enrolled and treated at a drug addiction outpatient clinic of the National Health System Local Unit in Milan, Italy.
  
  
  METHODS
  Two hundred fifty-seven subjects meeting the DSM-IV criteria for opioid dependence and opioid-seeking substitutive pharmacological treatment participated in the study.
  
  
  METHODS
  One hundred twenty-one subjects received BUP at a mean daily dose of 11 +/- 6 mg (median = 8; range = 2-30) for a mean duration of 249 days. One hundred thirty-six subjects received methadone at a mean daily dose of 54 +/- 29 mg (median = 50; range = 4-140) for a mean duration of 267 days.
  
  
  METHODS
  The main efficacy parameters were treatment retention rates and illicit substance abuse, as assessed by urinalysis.
  
  
  RESULTS
  Retention rates were comparable in both treatment groups, but BUP-treated subjects had significantly lower rates of illicit opiate consumption (p < .0001).
  
  
  CONCLUSIONS
  The results confirm that, in a nonexperimental clinical practice setting, BUP is as effective as methadone in the treatment of heroin dependence, with significantly better opiate abuse control, thus possibly allowing longer and more effective treatment programs with reduced relapse rates.
authors.affiliation: Public Out-patient Addiction Unit (SER.T), 25 via Boifava, ASL Città di Milano, Milan, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Vigezzi
authors.forename: Livia
authors.initials: L
authors.lastname: Guglielmino
authors.forename: Paolo
authors.initials: P
authors.lastname: Marzorati
authors.forename: Rosella
authors.initials: R
authors.lastname: Silenzio
authors.forename: Margherita
authors.initials: M
authors.lastname: De Chiara
authors.forename: Filomena
authors.initials: F
authors.lastname: Corrado
authors.forename: Laura
authors.initials: L
authors.lastname: Cocchi
authors.forename: Edoardo
authors.initials: E
authors.lastname: Cozzolino
mesh_terms: D000328:Adult; D002047:Buprenorphine / Q000627:therapeutic use*; D019970:Cocaine-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D006556:Heroin Dependence / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D009294:Narcotics / Q000627:therapeutic use*; D009788:Occupational Therapy; D011569:Psychiatric Status Rating Scales; D012944:Social Support; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D016896:Treatment Outcome
chemical_list: D009294:Narcotics; D002047:Buprenorphine; D008691:Methadone