Buprenorphine: a controlled clinical trial in the treatment of opioid dependence

Clinical trials carried out to compare methadone and buprenorphine in the t reatment of opioid dependence have generally employed an alcoholic solution of buprenorphine, which has a bioavailability superior to that of the tabl ets. Since the product available for large scale use is in tablet form, one intended to verify the efficacy of this formulation. In a multicentre rand omised controlled double blind study, 72 opioid dependent patients were ass igned to treatment with buprenorphine (8 mg/day) or methadone (60 mg/day) f or a period of 6 months. The two compounds did not show any significant dif ference with regard to urinalyses: the average percentage of analyses provi ng negative was 60.4% for patients assigned to buprenorphine, and 65.5% for those assigned to methadone. With regard to retention, a non-significant t rend in favour of methadone was observed. Patients completing the trial imp roved significantly in terms of psychosocial adjustment and global function ing, as ascertained by the DSM-IV-GAF and symptom checklist-90 (SCL-90) sca les, and this was independent of the treatment group. Finally, in the case of buprenorphine, patients who dropped out differed significantly from thos e who stayed, in terms of a higher level of psychopathological symptoms, an d a lower level of psychosocial functioning. The results of the study furth er support the utility of buprenorphine for the treatment of opioid depende nce. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.