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Buprenorphine Maintenance Best for Heroin Addicts

It is more effective than naltrexone in sustaining abstinence, delaying resumption of heroin use

FRIDAY, June 27 (HealthDay News) -- Maintenance treatment of detoxified heroin addicts with buprenorphine is more effective in sustaining abstinence and delaying resumption of heroin use compared with naltrexone or placebo, researchers report in the June 28 issue of The Lancet.

Richard S. Schottenfeld, M.D., from Yale University School of Medicine in New Haven, Conn., and colleagues randomly assigned 126 detoxified heroin-dependent patients from Malaysia to 24 weeks of drug counseling plus either naltrexone, buprenorphine or placebo.

The researchers found that over six months, buprenorphine was significantly more effective in improving retention in treatment, sustaining abstinence, and delaying the time to relapse and resumption of heroin use, though all three groups had reductions in injection drug use. There were no significant differences between naltrexone and placebo for any outcome. All three groups had significant reductions in HIV risk behaviors. The trial was stopped after 22 months of enrollment due to the greater efficacy of buprenorphine in early analyses.

"Our findings lend support to the widespread dissemination of maintenance treatment with buprenorphine as an effective public-health approach to reduce problems associated with heroin dependence," Schottenfeld and colleagues conclude.

Buprenorphine and buprenorphine placebo were provided at no cost by the manufacturer, Reckitt Benckiser.

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