In brief: Opiate maintenance alternatives: Two studies

In Brief

Opiate maintenance alternatives: Two studies

Two studies compare the standard methadone maintenance treatment for opiate addiction with alternatives, old and new. The results suggest that at least for some addicts, an older drug may be better, and the new approach is not methadone's equal.

The synthetic opioid methadone, taken by mouth, has become the mainstay of opiate addiction therapy, with more evidence in its favor than any other addiction treatment. It is a way to avoid the highs and lows, euphoria and withdrawal reactions, and other medical and social ills that result from intravenous injection of illicit drugs.

A new choice, available only since the mid-1990s, is the partial opioid agonist buprenorphine. It occupies opiate nerve receptors, preventing a withdrawal reaction, while blocking the effects of stronger opiates. Buprenorphine's greatest advantage is that, when combined with an opiate antagonist (to prevent recreational use), it can be prescribed by a physician to take at home rather than administered in a specialized clinic. In some studies, it has been found as effective as methadone.

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