TY - JOUR
T1 - A comparison of levomethadyl acetate, buprenorphine, and methadone for opioid dependence
AU - Johnson, R. E.
AU - Chutuape, M. A.
AU - Strain, E. C.
AU - Walsh, S. L.
AU - Stitzer, M. L.
AU - Bigelow, G. E.
PY - 2000/11/2
Y1 - 2000/11/2
N2 - Background: Opioid dependence is a chronic, relapsing disorder with important public health implications. Methods: In a 17-week randomized study of 220 patients, we compared levomethadyl acetate (75 to 115 mg), buprenorphine (16 to 32 mg), and high-dose (60 to 100 mg) and low-dose (20 mg) methadone as treatments for opioid dependence. Levomethadyl acetate and buprenorphine were administered three times a week. Methadone was administered daily. Doses were individualized except in the group assigned to low-dose methadone. Patients with poor responses to treatment were switched to methadone. Results: There were 55 patients in each group; 51 percent completed the trial. The mean (±SE) number of days that a patient remained in the study was significantly higher for those receiving levometha, dyl acetate (89±6), buprenorphine (96±4), and high-dose methadone (105±4) than for those receiving low-dose methadone (70±4, P<0.001). Continued participation in the study was also significantly more frequent among patients receiving high-dose methadone than among those receiving levomethadyl acetate (P=0.02). The percentage of patients with 12 or more consecutive opioid-negative urine specimens was 36 percent in the levomethadyl acetate group, 26 percent in the buprenorphine group, 28 percent in the high-dose methadone group, and 8 percent in the low-dose methadone group (P=0.005). At the time of their last report, patients reported on a scale of 0 to 100 that their drug problem had a mean severity of 35 with levomethadyl acetate, 34 with buprenorphine, 38 with high-dose methadone, and 53 with low-dose methadone (P=0.002). Conclusions: As compared with low-dose methadone, levomethadyl acetate, buprenorphine, and high-dose methadone substantially reduce the use of illicit opioids. (C) 2000, Massachusetts Medical Society.
AB - Background: Opioid dependence is a chronic, relapsing disorder with important public health implications. Methods: In a 17-week randomized study of 220 patients, we compared levomethadyl acetate (75 to 115 mg), buprenorphine (16 to 32 mg), and high-dose (60 to 100 mg) and low-dose (20 mg) methadone as treatments for opioid dependence. Levomethadyl acetate and buprenorphine were administered three times a week. Methadone was administered daily. Doses were individualized except in the group assigned to low-dose methadone. Patients with poor responses to treatment were switched to methadone. Results: There were 55 patients in each group; 51 percent completed the trial. The mean (±SE) number of days that a patient remained in the study was significantly higher for those receiving levometha, dyl acetate (89±6), buprenorphine (96±4), and high-dose methadone (105±4) than for those receiving low-dose methadone (70±4, P<0.001). Continued participation in the study was also significantly more frequent among patients receiving high-dose methadone than among those receiving levomethadyl acetate (P=0.02). The percentage of patients with 12 or more consecutive opioid-negative urine specimens was 36 percent in the levomethadyl acetate group, 26 percent in the buprenorphine group, 28 percent in the high-dose methadone group, and 8 percent in the low-dose methadone group (P=0.005). At the time of their last report, patients reported on a scale of 0 to 100 that their drug problem had a mean severity of 35 with levomethadyl acetate, 34 with buprenorphine, 38 with high-dose methadone, and 53 with low-dose methadone (P=0.002). Conclusions: As compared with low-dose methadone, levomethadyl acetate, buprenorphine, and high-dose methadone substantially reduce the use of illicit opioids. (C) 2000, Massachusetts Medical Society.
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U2 - 10.1056/NEJM200011023431802
DO - 10.1056/NEJM200011023431802
M3 - Article
C2 - 11058673
AN - SCOPUS:0034597736
SN - 0028-4793
VL - 343
SP - 1290
EP - 1297
JO - New England Journal of Medicine
JF - New England Journal of Medicine
IS - 18
ER -