Abstract

Taikato et al ( Psychiatric Bulletin , June 2005, 29 , 225-227) provide a useful summary of the benefits of buprenorphine as a treatment for heroin misuse. However, the optimism with which it is described may have misled readers. Most importantly, they claim superior efficacy compared with methadone

Highlights

  • In terms of the most important outcome measures (retaining individuals in treatment and reducing heroin use) a recent Cochrane review clearly came down on the side of methadone (Mattick et al, 2004)

  • An updated Cochrane review (Gowling et al, 2005) investigated the effectiveness of buprenorphine in managing opioid withdrawal/detoxification and concluded that buprenorphine was more effective than clonidine but that there was no significant difference compared with methadone in terms of completion of treatment

  • We were interested in the Cornwall experience and the difficulties encountered by community pharmacists with supervising buprenorphine administration

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Summary

Introduction

In terms of the most important outcome measures (retaining individuals in treatment and reducing heroin use) a recent Cochrane review clearly came down on the side of methadone (Mattick et al, 2004). This difficulty, which is in contrast to methadone, has led to diversion of buprenorphine onto the black market, and subsequent intravenous use. P., KIMBER, J., BREEN, C., et al (2004) Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence.The Cochrane Database of Systematic Reviews, issue 2.

Results
Conclusion

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