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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 (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, . 026988111771171. ISSN 0269-8811. (doi:10.1177/0269881117711710) (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided) (KAR id:62166)

The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided. (Contact us about this Publication)
Official URL
https://dx.doi.org/10.1177/0269881117711710

Abstract

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 ? ½ g heroin smoked/chased or ¼ 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<0.05, 95% confidence interval ?3.5, ?0.38). During detoxification, withdrawal symptoms were significantly greater and the peak of withdrawal was earlier for the methadone/lofexidine group than the buprenorphine/naloxone group (p<0.01, 95% confidence interval 3.0, 8.3). Methadone/lofexidine and buprenorphine/naloxone had comparable outcomes during rapid outpatient stabilisation and detoxification in low dose opiate users.

Item Type: Article
DOI/Identification number: 10.1177/0269881117711710
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research
Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Simon Coulton
Date Deposited: 30 Jun 2017 13:40 UTC
Last Modified: 22 Jan 2020 04:10 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/62166 (The current URI for this page, for reference purposes)
Coulton, Simon: https://orcid.org/0000-0002-7704-3274
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