First randomized controlled trial (RCT) of methadone (M), levomethadyl acetate (LAAM) and buprenorphine (BUP) in opioid dependence treatment

R. E. Johnson, M. A. Chutuape, E. C. Strain, S. L. Walsh, M. L. Stitzer, G. E. Bigelow

Research output: Contribution to journalArticle

Abstract

Purpose: To compare the efficacy of M, LAAM and BUP in a single RCT. Methods: Opioid dependent subjects (N=220; 55/group) stratified on age, race, sex, cocaine use, ASP, and marital status were randomized into a parallel group, double-blind, triple-dummy 17 week study. Flexible thrice weekly doses of LAAM and BUP and high (H) daily dose M were compared to 20 mg low (L) daily dose M. Urine specimens (US), self-reports (SR) and global assessments (GA) were collected 3 times weekly, weekly and monthly, respectively. Primary outcome measures were: 1) opioid-negative US, 2) sustained abstinence (≥4 wk), 3) SR of IV opioid use, 4) treatment retention, and 5) GA. Preliminary Results: US negative for opioids was 40% (HM), 39% (LAAM), and 34% (BUP) compared to 16% (LM; p<.01). Sustained abstinence was 28% (HM), 36% (LAAM) and 28% (BUP) compared to 10% (LM: p=.01). Treatment retention was 73% (HM), 53% (LAAM) and 58% (BUP) compared to 20% (LM; p<.003). At 17 weeks, SR of IV opioid use were reduced by 90% (HM), 89% (LAAM) and 92% (BUP), compared to 51% (LM). Group differences (p<.05) for GA of severity and change in drug problems were observed with greater improvement with HM, LAAM and BUP. Conclusions: All 3 medications are efficacious treatments for opioid dependence.

Original languageEnglish (US)
Number of pages1
JournalClinical pharmacology and therapeutics
Volume65
Issue number2
DOIs
StatePublished - Jan 1 1999

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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