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Drug helps heroin addicts stay clean

Buprenorphine helps heroin addicts stay clean, and widespread use of the drug could prove to be an effective public health measure, U.S. researchers say.

Their study of 126 detoxified heroin-dependent patients compared 24 weeks of treatment with naltrexone (a standard treatment), buprenorphine and placebo. The researchers compared maintenance of heroin abstinence, prevention of relapse, and reduction of HIV risk behaviour in the three groups of patients.

Those taking buprenorphine did best in terms of number of days to first heroin use, days to heroin relapse, and maximum consecutive days of abstinence.

Patients taking buprenorphine lasted almost twice as long until first heroin use compared to those in the naltrexone group, and just over twice as long as those in the placebo group. Patients taking buprenorphine lasted more than twice as long to heroin relapse and had more than twice as many continuous days of heroin abstinence as those taking the placebo.

HIV risk behaviours decreased in all three groups, mainly due to decreased injection drug use, but there were no significant differences between the groups.

"Our findings lend support to the widespread dissemination of treatment with buprenorphine as an effective public health approach to reduce problems associated with heroin dependence," concluded Dr. Richard Schottenfeld, of Yale University School of Medicine, and colleagues.

The study was published in this week's issue of The Lancet.

Health authorities in developing countries should no longer allow only oral naltrexone for the treatment of opioid dependence -- the preferred treatment should be maintenance with either buprenorphine or methadone, Dr. Wayne Hall and Dr. Richard Mattick of Australia wrote in an accompanying commentary.

Reference: Richard S Schottenfeld et al., 'Maintenance treatment with buprenorphine and naltrexone for heroin dependence in Malaysia: a randomised, double-blind, placebo-controlled trial', The Lancet 2008; 371:2192-2200

Article published on 12/08/2020 by PCUG Addiction Treatment