Medications Used in Opioid Maintenance Treatment

Christie Choo, PharmD, BCPS

Disclosures

US Pharmacist. 2009;34(11):1-5. 

In This Article

Clinical Efficacy of Methadone versus Buprenorphine

It is well established that both methadone and buprenorphine are effective for decreasing illicit drug use. It is worthwhile to consider the results of studies examining the efficacy of methadone versus buprenorphine.[7]

The 2008 Cochrane review determined that methadone dosed at 60 mg/day to 120 mg/day has superior efficacy compared with buprenorphine.[21] The specific studies yield varied results. One study found less illicit heroin use with buprenorphine than with methadone, but the methadone arm had higher retention rates.[22] Another study concluded that high-dose methadone had a higher retention rate and less illicit opioid use compared with buprenorphine 8 mg.[23] A double-blind, randomized trial comparing an average dose of buprenorphine (10 mg/day) versus methadone (70 mg/day) showed a higher retention rate with methadone, but found that the drugs had equal efficacy in reducing illicit heroin use.[24] However, a study from 1992 concluded that buprenorphine had better retention rates than methadone at 25 weeks.[26] Overall, it is accepted that buprenorphine and methadone have comparable efficacy and that treatment should be individualized.

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