COMPARISON OF BUPRENORPHINE AND METHADONE IN THE TREATMENT OF OPIOID DEPENDENCE

Objective: This study compared the efficacy of buprenorphine and metha done in the treatment of opioid dependence, Method: Participants (N=16 4) were relatively treatment-naive, opioid-dependent applicants to a 2 6-week treatment program who were randomly assigned to either methadon e or buprenorphine treatment. Dosing was double-blind and double-dummy . Patients were stabilized on a regimen of either methadone, 50 mg, or buprenorphine, 8 mg, with dose changes possible through week 16 of tr eatment. urine samples were collected three times a week, and weekly c ounseling was provided. Results: Buprenorphine (mean dose=8.9 mg/day) and methadone (mean dose=54 mg/day) were equally effective in sustaini ng retention in treatment, compliance with medication, and counseling regimens. In both groups, 56% of patients remained in treatment throug h the 16-week flexible dosing period. Overall opioid-positive urine sa mple rates were 55% and 47% for buprenorphine and methadone groups, re spectively; cocaine-positive urine sample rates were 70% and 58%. Evid ence was obtained for the effectiveness of dose increases in suppressi ng opioid, but not cocaine, use among those who received dose increase s. Conclusions: The results of this study provide further support for the utility of buprenorphine as a new medication in the treatment of o pioid dependence and demonstrate efficacy equivalent to that of methad one when used during a clinically guided flexible dosing procedure.