Buprenorphine/naloxone versus methadone and lofexidine in community stabilisation and detoxification: A randomised controlled trial of low dose short-term opiate-dependent individuals

Law, Fergus D.; Diaper, Alison M.; Melichar, Jan K.; Coulton, Simon; Nutt, David J.; Myles, Judy S.

Abstract

© British Association for Psychopharmacology. Buprenorphine/naloxone, methadone and lofexidine are medications with utility in the treatment of opiate withdrawal. We report the first randomised controlled trial to compare the effects of these two medications on withdrawal symptoms and outcome during opiate induction/stabilisation and detoxification. A double-blind randomised controlled trial was conducted in an outpatient satellite clinic of a specialist drug service. Eighty opiate dependent individuals meeting DSM-IV criteria for opiate dependence, using ≤ 1/2 g heroin smoked/chased or 1/4 g heroin injected or ≤ 30mg methadone, with ≤ 3 years of opioid dependency, underwent a short-term opiate treatment programme involving induction/stabilisation on methadone 30mg or buprenorphine/naloxone 4mg/1mg, followed by detoxification (where the methadone group was assisted by lofexidine). The main outcome measures were urine drug screens for opiates and withdrawal and craving questionnaires. There were no overall differences in positive urine drug screens and drop-outs during any phase of the study. During induction/stabilisation, withdrawal symptoms subsided more slowly for buprenorphine/naloxone than for methadone, and craving was significantly higher in the buprenorphine/naloxone group (p

• Journal Article Type: Article
• Acceptance Date: Jun 20, 2017
• Online Publication Date: Jun 20, 2017
• Publication Date: Aug 1, 2017
• Deposit Date: Nov 21, 2019
• Journal: Journal of Psychopharmacology
• Print ISSN: 0269-8811
• Electronic ISSN: 1461-7285
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• Volume: 31
• Issue: 8
• Pages: 1046-1055
• DOI: https://doi.org/10.1177/0269881117711710
• Public URL: https://uwe-repository.worktribe.com/output/4670072
• Publisher URL: https://doi.org/10.1177/0269881117711710