Medically assisted recovery from opiate dependence within the context of the UK drug strategy: Methadone and Suboxone (buprenorphine-naloxone) patients compared
Journal of Substance Abuse Treatment, 06/21/2012
McKeganey N et al. – The positive but preliminary indications of the comparative efficacy of methadone and Suboxone for treating opiate dependence now require replication in a well–powered, randomised controlled trial.Methods
- All patients had been prescribed either methadone or Suboxone for maintenance for 6months prior to intake.
- Results showed that when controlling for a number of patient-level covariates, both methadone and Suboxone significantly reduced current users' days of heroin use between the 90days prior to intake and at the 8-month follow-up, yielding a significantly larger magnitude reduction in heroin use days than methadone.
- Methadone and Suboxone were highly and equally effective for preventing relapse to regular heroin use, with all but 3 of 37 (91.9%) patients who were abstinent at intake reporting past 90-day point prevalence heroin abstinence at the 8-month follow-up.
- Overall, prescribing methadone or Suboxone for eight continuous months was highly effective for initiating abstinence from heroin use, and for converting short-term abstinence to long-term abstinence.
- However, the study design, which was based on a relatively small sample size and was not able randomise patients to medication and so could not control for the effects of potential prognostic factors inherent within each patient group, means that these conclusions can only be made tentatively.