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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.

Authors

Fergus D. Law

Jan K. Melichar

Simon Coulton

David J. Nutt

Judy S. Myles



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

Citation

Law, F. D., Diaper, A. M., Melichar, J. K., Coulton, S., Nutt, D. J., & Myles, J. S. (2017). Buprenorphine/naloxone versus methadone and lofexidine in community stabilisation and detoxification: A randomised controlled trial of low dose short-term opiate-dependent individuals. Journal of Psychopharmacology, 31(8), 1046-1055. https://doi.org/10.1177/0269881117711710

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