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STUDY 2010 HTM file
The SUMMIT Trial: a field comparison of buprenorphine versus methadone maintenance treatment
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.
STUDY 2010 HTM file
Long-term outcomes of office-based buprenorphine/naloxone maintenance therapy
Abstinence and recovery characterised by employment are priority UK policy objectives to which the extension of mutual aid is considered a major route. This US study illustrates that both the route and the objectives are not just compatible with, but may be promoted by opiate maintenance prescribing.
STUDY 2010 HTM file
Unobserved versus observed office buprenorphine/naloxone induction: a pilot randomized clinical trial
Having for several hours to medically monitor opiate-addicted patients starting buprenorphine maintenance is a major impediment to spreading the benefits of the treatment, but this first randomised trial suggests that many patients can manage the process safely at home.
STUDY 2011 HTM file
Adjunctive counseling during brief and extended buprenorphine-naloxone treatment for prescription opioid dependence
From the USA, the first large study to randomly allocate patients dependent on prescription opioids to different treatments found that despite wanting to detoxify, all but a few relapsed after withdrawal from substitute medication; more intensive and specialist counselling did not help.
STUDY 2010 HTM file
Home- versus office-based buprenorphine inductions for opioid-dependent patients
Is is safe and will heroin-dependent patients complete the process and stay in treatment if they start buprenorphine maintenance at home rather than being observed and doses adjusted at the clinic? This US study suggests this is feasible, saving time for all concerned, but also hints at possible (in this case, rare) complications.
REVIEW 2012 HTM file
Effect of buprenorphine dose on treatment outcome
How much buprenorphine does it take to keep patients in treatment and suppress illicit use of heroin or other opiate-type drugs? This review concludes that on average higher is better than lower, but that individualising dose and a preparedness to go high if needed are the keys to effective treatment.
REVIEW 2014 HTM file
A review of buprenorphine diversion and misuse: the current evidence base and experiences from around the world
Practice-oriented review of what we know about the diversion (to other people) and misuse (mainly by injecting it) of buprenorphine used in the treatment of opiate dependence, featuring extended, practical guidance on how to identify and respond to these life-threatening behaviours as a therapeutic challenge rather than a disciplinary issue.
DOCUMENT 2009 HTM file
Buprenorphine: a guide for nurses
Comprehensive guide from the US health department’s substance use treatment authority for nurses involved in buprenorphine-based treatment for dependence on opiate-type drugs like heroin, including detoxification and substitute prescribing.
STUDY 2013 HTM file
Medically assisted recovery from opiate dependence within the context of the UK drug strategy: methadone and suboxone (buprenorphine-naloxone) patients compared
Opiate dependent patients in Scotland who opted for or were allocated to methadone sustained their abstinence from heroin as well as those on buprenorphine, but buprenorphine was far better at helping continuing heroin users cut back – suggestive, but the study’s constraints make the practice implications unclear.
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.
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