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Volume 4, Issue Suppl. 1
October 1998
Research Articles| October 15 1998
Subject Area: Pharmacology , Psychiatry and Psychology , Public Health
Harald Eder;
Harald Eder
a Department of General Psychiatry, University Hospital of Psychiatry,
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Gabriele Fischer;
Gabriele Fischer
a Department of General Psychiatry, University Hospital of Psychiatry,
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Wolfgang Gombas;
Wolfgang Gombas
a Department of General Psychiatry, University Hospital of Psychiatry,
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Reinhold Jagsch;
Reinhold Jagsch
a Department of General Psychiatry, University Hospital of Psychiatry,
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Georg Stühlinger;
Georg Stühlinger
b University Clinic of Emergency Medicine, Währinger Gürtel, Vienna, Austria
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Siegfried Kasper
Siegfried Kasper
a Department of General Psychiatry, University Hospital of Psychiatry,
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Eur Addict Res (1998) 4 (Suppl. 1): 3–7.
Article history
Published Online:
October 15 1998
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Citation
Harald Eder, Gabriele Fischer, Wolfgang Gombas, Reinhold Jagsch, Georg Stühlinger, Siegfried Kasper; Comparison of Buprenorphine and Methadone Maintenance in Opiate Addicts. Eur Addict Res 1 October 1998; 4 (Suppl. 1): 3–7. https://doi.org/10.1159/000052034
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Abstract
As a maintenance agent for opioid dependency, buprenorphine offers advantages such as a lower level of dependence and minimal withdrawal symptoms, due to its partial agonist properties at the µ-opioid receptor. Previous studies have shown 8mg sublingual buprenorphine to be equivalent to 60mg oral methadone in terms of retention rate and opioid-negative urine levels. In a 24-week, ongoing European study, 34 opioid-dependent subjects were assessed; 16 receiving buprenorphine and 18 methadone. A free dosing schedule was used with no upper limit for methadone dosing but with a maximum buprenorphine dose of 8mg. Screening prior to the study excluded subjects with polysubstance dependence, somatic disease and/or HIV infection. Primary outcome measures were abstinence from other drugs, for which subjects provided weekly urine samples for analysis of opioids, cocaine and benzodiazepines, and retention in treatment. Patients in the buprenorphine group provided a greater proportion of negative urine samples, in particular cocaine-negative samples, compared with the methadone group, although this was not statistically significant. Retention in the buprenorphine group was significantly lower than in the methadone group, suggesting that the 8 mg buprenorphine limit may have biased the results in favour of methadone, and that this dose may have been too low for those subjects with high levels of dependence. However, buprenorphine is clearly effective in the more motivated subjects and further investigation in this subgroup is recommended.
Keywords:
Buprenorphine, Maintenance therapy, Drug addiction, Methadone
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1998
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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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