Quality of Life in Opioid Replacement Therapy: A Naturalistic Cross-Sectional Comparison of Methadone/Levomethadone, Buprenorphine, and Diamorphine Patients

Abstract

<b><i>Background:</i></b> Research on quality of life (QoL) of chronically ill patients provides an opportunity to evaluate the efficacy of long-term treatments. Although it is established that opioid replacement therapy is an effective treatment for opioid-dependent patients, there is little knowledge about physical and psychological functioning of QoL for different treatment options. <b><i>Objectives:</i></b> Altogether, 248 opioid-dependent patients receiving substitution treatment with either methadone/levomethadone (<i>n</i> = 126), diamorphine (<i>n</i> = 85), or buprenorphine (<i>n</i> = 37) were recruited in 6 German therapy centers. <b><i>Methods:</i></b> Sociodemographic data were collected. QoL – physical and psychological functioning – for different substitutes was assessed using the <i>Profile of the Quality of Life in the Chronically Ill</i> (PLC) questionnaire. <b><i>Results:</i></b> Patient groups were similar regarding age and duration of opioid dependence. Employment rate was significantly higher (<i>p</i> < 0.005, φ = 0.22) in the buprenorphine group (46%) compared to methadone (18%). Dosage adjustments were more frequent (<i>p</i> < 0.001, φ = 0.29) in diamorphine (55%) than in methadone (30%) or buprenorphine (19%) patients. Buprenorphine and diamorphine patients rated their physical functioning substantially higher than methadone patients (<i>p</i> < 0.001, η<sup>2</sup> = 0.141). Diamorphine patients reported a higher psychological functioning (<i>p</i> < 0.001, η<sup>2</sup> = 0.078) and overall life improvement (<i>p</i> < 0.001, η<sup>2</sup> = 0.060) compared to methadone, but not compared to buprenorphine patients (both <i>p</i> > 0.25). <b><i>Conclusion:</i></b> Measurement of important QoL aspects indicates significant differences for physical and psychological functioning in patients receiving the substitutes methadone/levomethadone, diamorphine, and buprenorphine. This could be relevant for the differential therapy of opioid addiction.

Multicenter Observational/Exploratory Study Addressed to the Evaluation of the Effectiveness and Safety of Pharmacological Therapy in Opioid-Dependent Patients in Maintenance Therapy in Southern Italy

“…The quality of life was not quantified in our study. This is reported to be superior with other drugs, rather than rac-methadone/levomethadone, as buprenorphine and diamorphine patients rated their physical functioning substantially higher than methadone patients [15]. Buprenorfine also showed more favorable metabolic effects vs. other drugs in these patients [44].…”

“…Buprenorphine reduces these effects. The partial competition of opiate receptors makes the molecule a valid alternative to methadone, as the µ risk of respiratory depression from overdose is greatly reduced [14][15][16][17][18]. This is especially important in the drug addict population.…”

Correlation Between Mental Quality and Training Intensity in University Swimmers

“…The experimental group cultivated the psychological quality of sports competition through psychological self-control exercise. 6 The control group adopted relaxation training, tension training, thought control training, and attention concentration training to cultivate the psychological quality of the simulation competition. The athlete joined the tactical swimming exercise in addition to the mental training.…”

The switching process from buprenorphine sublingual tablets to the monthly buprenorphine subcutaneous depot injection in opioid dependent patients

“…10 The since millennium increasingly prescribed partial-agonist buprenorphine is-compared with the commonly prescribed opioid agonists methadone and levomethadoneIconsidered a less sedative, more activating and anti-depressant substitute with the advantage of the socalled "Ceilling-effect", which greatly reduces the risk of overdosing. [11][12][13][14][15][16] In 2018, the so-called buprenorphine weekly or monthly depot injection Buvidal ® received its approval in Germany. 17 As an extended-release depot, it releases a daily constant dose of the active ingredient buprenorphine.…”