Sublingual Buprenorphine and Methadone Maintenance Treatment: A Three-Year Follow-Up of Quality of Life Assessment

Abstract

This study was conducted to compare long-term outcome effects on the quality of life (QOL) of oral methadone with sublingual buprenorphine maintenance treatment. The QOL status of opioid-dependent patients was assessed using the German version (“Berlin Quality of Life Profile”) of the Lancashire Quality of Life Profile. Physical symptoms were measured using the Opiate Withdrawal Scale (OWS). Urine tests were carried out randomly to detect additional consumption. In the first study period, 53 opioid-dependent subjects were enrolled and 25 could be reached after 3 years. The retention rate was 50% for methadone and 45% for buprenorphine (p = 0.786). Baseline values of the total sample (completers and noncompleters) QOL and somatic complaints did not show significant differences between the two treatment groups. QOL characteristics at 6 months of treatment of the buprenorphine completer and noncompleter groups differed significantly regarding job (p = 0.013), family, and total score of physical symptoms (p = 0.002), in which the completer group showed the more favorable values. Concerning physical symptoms at 36 months, logistic regression revealed significantly less stomach cramps (p = 0.037) and fatigue and tiredness (p = 0.034) in buprenorphine compared to the methadone. Moreover, the buprenorphine-maintained group showed significantly less additional consumption of benzodiazepines (p = 0.015) compared with methadone participants. It is concluded that opioid addicts improved their QOL and health status when treated with methadone or buprenorphine. In summary, regarding QOL and health status, the present data indicate that buprenorphine is also a useful long-term alternative for maintenance treatment of opioid-dependent patients.

Substance Abuse Treatment Utilizing Medication Assisted Treatment as HIV Prevention

“…Methadone treatment is effective as both primary and secondary HIV prevention (Kerr et al 2004) and cost-effective to society (Barnett et al 2001;Doran et al 2003). In addition to improving health outcomes, methadone treatment also substantially improves the quality of life of patients over the course of methadone treatment (Giacomuzzi et al 2005). Barriers to retention in methadone treatment include the severity of drug, medical and social problems at initiation of treatment, as well as patient readiness for treatment and motivation.…”

Maintenance Therapy and Sexual Behavior

“…Methadone diminishes the euphoric effects of other opioids (cross tolerance), without necessarily causing euphoria, sedation or analgesia. This means that self-administered illicit opioids will not lead to euphoria, making it less likely that clients/patients will either use illicit opioids or overdose (Giacomuzzi, 2008). Methadone maintenance treatment has been demonstrated to be an effective treatment for opioid addiction and curbs the incidence thereof.…”

“…Addiction is currently also defined as a form of behavior through which an individual has impaired control with harmful consequences. Thus, individuals who recognize that their behavior is harming them or those they care about find themselves unable to stop engaging in the behavior when they try to do so (Giacomuzzi, 2008). The severity of the medical, psychological and social harm that can be caused by addiction, together with the fact that it violates the individual's freedom of choice, means that it is appropriate to consider it to be a disorder of motivation.…”

“…Methadone was originally developed in Germany as a substitute analgesic for morphine. World War II brought the formula to the attention of North American researchers, who subsequently discovered that methadone could be used to treat heroin withdrawal symptoms in 1964 as a medical response to the post-World War II heroin epidemic in New York City (Giacomuzzi, 2008). The principal effects of methadone maintenance are to relieve narcotic craving, suppress the abstinence syndrome, and block the euphoric effects associated with heroin.…”

Advancing Service Integration in Opioid Treatment Progams for the Care and Treatment of Hepatitis C Infection

“…Life priorities of injection drug users include, a concern about and treatment of infectious diseases, such as hepatitis C infection, as well as, social and fiscal issues such as housing, money, and protection from violence [9]. Studies have shown that individuals receiving methadone treatment are at a reduced risk of death, less involved in crime, and have an enhanced quality of life, with positive cognitive, emotional, and social functioning [10][11][12][13].…”