Methadone Versus Buprenorphine With Contingency Management or Performance Feedback for Cocaine and Opioid Dependence

Physicians may prescribe buprenorphine for opioid agonist maintenance treatment outside of narcotic treatment programs, but treatment guidelines for patients with co-occurring cocaine and opioid dependence are not available.

This study compares effects of buprenorphine and methadone and evaluates the efficacy of combining contingency management with maintenance treatment for patients with co-occurring cocaine and opioid dependence.

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Indicators of Buprenorphine and Methadone Use and Abuse: What Do We Know?

Abuse of prescription opioids is a growing problem. The number of methadone pain pills distributed now exceeds liquid methadone used in opioid treatment, and the increases in buprenorphine indicators provide evidence of the need to monitor and intervene to decrease the abuse of this drug. The need for additional and improved data to track trends is discussed, along with findings as to the characteristics of the users and combinations of drugs. Data on toxicities related to methadone or buprenorphine, particularly in combination with other prescribed drugs, are presented and clinical implications and considerations are offered. These findings underscore the need for physicians to be aware of potential toxicities and to educate their patients regarding these issues.

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LOWERING the THRESHOLD Models of Accessible Methadone and Buprenorphine Treatment

Sixty-five countries now offer the medications buprenorphine and methadone to treat opiate addiction. Deemed “essential medicines” by the World Health Organization they are recognized by the United Nations Office on Drugs and Crime, UNAIDS, and multiple national, regional, and international medical organizations to reduce drug injection and drug-related crime, and to improve public order, family satisfaction, return to employment, and adherence to HIV treatment.

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How should journalists cover drug dependence?

Journalists usually learn it early: Drug stories are crime stories. Articles about alcoholism and assorted “hard” drug addictions are typically sourced by law enforcement, and the frequently lurid results tend to dump recreational, illegal, and prescription drugs into the same stew.

This is a particular problem for patients on opioid substitution therapy, who take maintenance drugs such as methadone and buprenorphine (Suboxone). Both drugs are the subject of black markets the size of which is difficult to pin down, but the vast majority of users take the drugs under medical supervision in government-supervised health and social programs.

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Buprenorphine for the management of opioid withdrawal

The Cochrane Collaboration have reccently published Buprenorphine for the management of opioid withdrawal. The objective of the research was to assess the effectiveness of interventions involving the use of buprenorphine to manage opioid withdrawal, for withdrawal signs and symptoms, completion of withdrawal and adverse effects.

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A 50-Year-Old Woman Addicted to Heroin Review of Treatment of Heroin Addiction

Heroin addiction is a complicated medical and psychiatric issue, with well-established as well as newer modes
of treatment. The case of Ms W, a 50-year-old woman with a long history of opiate addiction who has been
treated successfully with methadone for 9 years and who now would like to consider newer alternatives, illustrates
the complex issues of heroin addiction. The treatment of heroin addiction as a chronic disease is reviewed,
including social, medical, and cultural issues and pharmacologic treatment with methadone and the more
experimental medication options of buprenorphine and naltrexone.

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