Multimodal drug addiction treatment: a field comparison of methadone and buprenorphine among heroin- and cocaine-dependent patients.
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.
Vigezzi
Pierluigi
P
Public Out-patient Addiction Unit (SER.T), 25 via Boifava, ASL Città di Milano, Milan, Italy.
Guglielmino
Livia
L
Marzorati
Paolo
P
Silenzio
Rosella
R
De Chiara
Margherita
M
Corrado
Filomena
F
Cocchi
Laura
L
Cozzolino
Edoardo
E
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
D009294:Narcotics; D002047:Buprenorphine; D008691:Methadone