PubMed:26599131 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PubMed/sourceid/26599131","sourcedb":"PubMed","sourceid":"26599131","source_url":"http://www.ncbi.nlm.nih.gov/pubmed/26599131","text":"Long-term outcomes after randomization to buprenorphine/naloxone versus methadone in a multi-site trial.\nAIMS: To compare long-term outcomes among participants randomized to buprenorphine or methadone.\nDESIGN/SETTING/PARTICIPANTS: Follow-up was conducted in 2011-2014 of 1,080 opioid-dependent participants entering 7 opioid treatment programs in the USA between 2006 and 2009 and randomized (within each program) to receive open-label buprenorphine/naloxone or methadone for up to 24 weeks; 795 participants completed in-person interviews (~74% follow-up interview rate) covering on average 4.5 years.\nMEASUREMENTS: Outcomes were indicated by mortality and opioid use. Covariates included demographics, site, cocaine use, and treatment experiences.\nFINDINGS: Mortality was not different between the two randomized conditions with 23 (3.6%) of 630 participants randomized to buprenorphine having died, versus 26 (5.8%) of 450 participants randomized to methadone. Opioid use at follow-up was higher among participants randomized to buprenorphine relative to methadone (42.8% vs. 31.7% positive opioid urine specimens, p \u003c .01, effect size (h) = 0.23 [0.09, 0.38]; 5.8 days vs. 4.4 days of past 30-day heroin use, p \u003c .05, effect size (d) = 0.14 [0.00, 0.28]). Opioid use over the follow-up period by randomization condition was also significant (F(7,39600) = 3.16; p \u003c .001) mostly due to less treatment participation among participants randomized to buprenorphine than methadone. Less opioid use was associated with both buprenorphine and methadone treatment (relative to no treatment); no difference was found between the two treatments. Individuals who are white or used cocaine at baseline responded better to methadone than to buprenorphine.\nCONCLUSIONS: There are few differences in long-term outcomes between buprenorphine and methadone treatment for opioid dependence, and treatment with each medication is associated with a strong reduction in opioid use. This article is protected by copyright. All rights 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