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DOCUMENT 2011 HTM file
Buprenorphine/naloxone for opioid dependence: clinical practice guideline
Though tailored for Canada, these guidelines from an internationally respected centre offer valuable guidance to clinicians in Britain and elsewhere on a form of the main alternative to methadone for the maintenance treatment of addiction to heroin and allied drugs, one whose greater safety counterbalances greater cost.
Opiate dependent methadone patients in Belgium give their own accounts of what for them constitutes a good quality of life. Generally they want what other people want: a meaningful, independent life and supportive relationships. Methadone creates the preconditions for such a life at the same time as it limits its achievement.
Methadone maintained heroin-dependent patients in Birmingham (UK) randomised to inpatient v. outpatient lofexidine-based detoxification rarely sustained long-term opioid abstinence; return to maintenance was the typical outcome.
Compared to methadone, buprenorphine is more often chosen in a make-or-break attempt to divorce oneself from illicit opiates found the first large-scale study to compare the drugs in real-life conditions at a British opiate addiction maintenance treatment programme.
Limited access to opiate substitute prescribing in Norway opened a window on its powerful lifesaving potential, a view obscured in countries where barriers create a confounding selection effect or where everyone who needs and wants this treatment can quickly get it.
STUDY 2004 PDF file 159Kb
Methadone maintenance as low-cost lifesaver
US studies find that even when slow methadone detoxification is bolstered by psychosocial therapy and aftercare, methadone maintenance does better at prolonging the lives of opiate-dependent patients at relatively little extra cost.
REVIEW 2003 PDF file 925Kb
Controversial, expensive, yet promising so much, interest is increasing in prescribing heroin to heroin addicts. Just five studies hold what answers there are to whether this can work, including a probably unrepeatable early British study.
STUDY 2003 PDF file 235Kb
First large-scale randomised trial boosts case for heroin prescribing
From the Netherlands, the first large-scale, randomised trial found that for patients previously failed by oral methadone, prescribing injectable or smokable heroin instead greatly reduces crime and improves health and social functioning.
STUDY 1999 PDF file 255Kb
Methadone treatment cost-effective life saver
Three studies which show that getting in to and staying in methadone treatment cost-effectively saves the lives of heroin addicts. Conversely, being denied treatment or discharged for rule-breaking costs lives.
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