Buprenorphine may be safer than methadone if treatment duration is longer, study suggests
our findings clearly suggest that buprenorphine may be the safer treatment option
The less commonly prescribed opioid substitute buprenorphine may be safer than methadone for problem opioid users, especially if used during the first month of treatment, according to a study which includes University of Manchester researchers. The University of Bristol led study, funded by the National Institute for Health Research (NIHR) and published in the journal Addiction online today, analysed GP practice data for over 11,000 patients on opioid substitute treatment linked to deaths data. It assessed the relative risk of death for the two treatments, compared to not being in treatment, over three time periods: in the first four weeks of starting treatment, during the rest of treatment, and in the first four weeks after treatment ended. Roughly a third of patients receiving opioid substitute treatment were prescribed buprenorphine and two-thirds methadone. As previously shown, risk of death is higher at the beginning and immediately after the end of treatment, the basis for the argument that retaining patients in treatment for longer periods will save lives.
The new study shows that patients on buprenorphine had substantially lower rates of overdose death during treatment compared to those on methadone: four times lower in the first 4 weeks (0.3 percent compared with 1.24 percent) and almost twice as low during the rest of time on treatment (0.18 percent compared with 0.33 percent).
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