COMPARISON OF BUPRENORPHINE AND METHADONE IN THE TREATMENT OF OPIOID DEPENDENCE - SWISS MULTICENTER STUDY

A three-centre, randomised, double-blind study was designed to compare the efficacy and safety of buprenorphine and methadone. This was the first European study to compare these agents and was based on a previo us trial performed in the US. Opioid-dependent subjects were randomise d to receive either sublingual buprenorphine or oral methadone daily. Both objective and subjective measures of efficacy were monitored week ly, and safety parameters were regularly monitored over the entire six -week study. Urinalysis showed that the two treatments were similar wi th a slight increase in opioid-negative urines noted in both groups. T he retention rate in the buprenorphine group was lower than in the met hadone group, although it has been suggested that the buprenorphine do se may have been too low for some patients. None of the side effects n oted were considered serious and all were attributable to chronic opio id dependence. Experience of two years substitution treatment in Fribo urg suggests that initial induction onto buprenorphine allows for pati ents to be subgrouped before being given the most appropriate maintena nce agent. Further investigation is required into the different dose-r elated effects of buprenorphine seen in particular subsets of addicts.