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Prognostic Factors in Buprenorphine- versus Methadone-Maintained Patients

SCHOTTENFELD, RICHARD S. M.D.1,2; PAKES, JULIANA R. M.Ed.1; KOSTEN, THOMAS R. M.D.1,3

Journal of Nervous & Mental Disease: January 1998 - Volume 186 - Issue 1 - pp 35-43
Articles

This study a) compared the effects of buprenorphine versus methadone maintenance on benzodiazepine and alcohol use and b) evaluated the prognostic significance of gender and psychopathology and their interaction with maintenance treatment. Eighty male and 36 female patients were randomly assigned to daily sublingual buprenorphine (4 or 12 mg) or oral methadone (20 or 65 mg). Maintenance medication was not associated with significant differences in alcohol or benzodiazepine use. Rates of abstinence from illicit opioids were significantly higher for females; within the buprenorphine 4-mg group, females also had significantly better retention, lower rates of opioid-positive urine samples, and higher rates of abstinence from illicit opioids. Lifetime sedative dependence was associated with significantly better retention, decreased rates of cocaine-positive urine samples, and increased rates of cocaine abstinence; among buprenorphine- but not methadone-maintained patients, it was also associated with increased rates of abstinence from illicit opioids.

1 Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.

Send requests for reprints to Dr. Schottenfeld, CMHC/SAC, 34 Park Street, S204, New Haven, Connecticut 06519.

2 The APT Foundation, Inc., New Haven, Connecticut.

3 West Haven Veterans' Administration Medical Center, West Haven, Connecticut.

This research was supported by the National Institute on Drug Abuse grants K02-DA0112, R18-DA06190, and R01-DA06266.

© Williams & Wilkins 1998. All Rights Reserved.