NCJ Number
196099
Journal
Drug and Alcohol Dependence Volume: 65 Issue: 3 Dated: February 1, 2002 Pages: 283-290
Date Published
2002
Length
8 pages
Annotation
This study provided an analysis of the retention rate and opioid use during methadone maintenance.
Abstract
Methadone maintenance treatment has become an extensively used intervention because of its ability to reduce illegal opioid consumption. This meta-analysis was conducted to determine the effect of methadone maintenance strategies on the endpoints of retention rate and reduction of illicit opioid use. Studies eligible for inclusion in the meta-analysis were retrieved from the PubMed database for 1966 to December 1999. In order to be selected for the study, articles had to be randomized, controlled, and double-blind clinical trials with methadone as the study drug; length of methadone maintenance treatment more than 12 weeks; dose(s) of methadone clearly stated; and measures of retention rates based on analytical determination of drugs of abuse in urine samples as outcome variables. The study compared the effectiveness of methadone, buprenorphine, and levo-acetylmethadol (LAAM) in long-term treatment in opioid dependence. It showed that methadone administered at doses of more than 50 mg/day and buprenorphine more than 8 mg/day were similar in terms of retention in treatment. They were both better than LAAM where the probability of failure in retention was almost two-fold in relation to methadone. The three treatment modalities showed similar efficacy in reducing illicit opioid use. The results demonstrate that methadone, when administered at does of 50 mg/day or higher, continues to be the drug of choice for treating opioid dependence in programs based on agonist-maintenance. The new drugs, buprenorphine or LAAM, do not seem superior to methadone in terms of efficacy. The most important advantage of LAAM and buprenorphine is the 3-days a week schedule. The newer drugs also can be an alternative for some patients who present problems with methadone administration or refuse to take the drug. The other benefits related to decreases in HIV risk behavior and criminality and improvements in health-related quality of life already reported for methadone have yet to be demonstrated for buprenorphine and LAAM. 1 figure, 1 table, 54 references