Multimodal drug addiction treatment: A field comparison of methadone and buprenorphine among heroin- and cocaine-dependent patients

The SUMMIT Trial:

“…This was demonstrated in several ways including an overall reduction in the number of urine samples positive for opiates, increased rates of sustained abstinence from illicit use, and increased rates of progression to detoxification. These findings are in contrast to previous randomized trials but similar to the results that Vigezzi et al (2006) found in another nonrandomized, nonblinded field trial. In addition, our results suggest that BMT may be associated with reduced alcohol use but did not demonstrate any difference in social functioning or psychological health.…”

“…Furthermore, our results suggest that above 8 mg increasing doses for buprenorphine did not improve retention. No studies to date have specifically compared retention for doses greater than 8 mg, but four studies, which examined dose of buprenorphine as a predictor of retention in a secondary analysis, failed to find a relationship (Gerra et al, 2004(Gerra et al, , 2006Soyka, Zingg, Koller, & Kuefner, 2008;Vigezzi et al, 2006). Kakko et al (2007) reported 78% retention using a very high mean dose (29 mg), but this was an intention-totreat analysis where only 35% of the BMT group actually remained on buprenorphine at 6 months.…”

Predictors of Outcome During a 6-Month Follow-Up Among Heroin Dependent Patients Receiving Buprenorphine/Naloxone Maintenance Treatment

“…One of the important findings of the present study was that, while craving and withdrawal were higher in the group with a negative outcome, the mean dose of BN for stabilization did not differ between the groups. The mean dose of BN in the first 2 weeks was not associated with outcome, similar to the findings in patients treated with comparable mean daily doses of 9-12 mg 35,37,62 . In one observational study, initial induction doses of 16 mg were associated with better retention 38 .…”

One-Year and Cumulative Retention as Predictors of Success in Methadone Maintenance Treatment: A Comparison of Two Clinics in the United States and Israel

“…Retention in treatment, however, which is the other major outcome, differed between clinics. Specifically, the 1 year retention rate was higher in Tel-Aviv than in Las Vegas (74.4% vs. 61.6%), but both clinics presented high retention rates compared to other clinics throughout the world whose retention rates have been reported: 1 year retention rate was 48% in 674 patients from Massachusetts and Connecticut MMT clinics; 10 52% in 338 MMT patients from New York; 11 60% in 1,487 MMT patients from Spain; 12 38.4% in 477 from Australia; 13 61% in 136 MMT and 65% in 121 buprenorphine patients from Italy; 14 and 43.8% in 206 other buprenorphine patients from Italy. 15 Comparing the two clinics with respect to patients' characteristics on admission, the Las Vegas patients were admitted when they were older (mean = 43.4 years) than the Tel-Aviv patients (mean = 36.7 years).…”