Comparison to Other Opioid Treatments

Methadone is the only other approved opioid maintenance treatment. While methadone is inexpensive and well-studied treatment and may be the appropriate treatment for certain patients, there are several advantages of buprenorphine over methadone. Buprenorphine:

  • Is a Schedule III narcotic drug, while methadone is Schedule II - more tightly controlled - and is not approved for office-based treatment.
  • Produces milder withdrawal symptoms than methadone and has a lower risk of overdose due to ceiling effect
  • Is less likely to be diverted due to its combination with naloxone (Krantz and Mehler, 2004).

In a recent meta-analysis of research, Connock et al. (2007) found:

  • For flexible doses, methadone (20-120 mg daily) had superior retention in treatment to buprenorphine (4-16 mg daily)
  • no significant difference in opioid use
  • level of mortality may be lower with buprenorphine
  • no significant difference in rate of serious adverse events
View ReferencesHide References
Connock, M, Juarez-Garcia, , Jowett, S, Frew, E, Liu, Z, Taylor, RJ, Fry-Smith, A, Day, E, Lintzeris, N, Roberts, T, Burls, A, Taylor, RS. Methadone and buprenorphine for the management of opioid dependence: a systematic review and economic evaluation. Health Technology Assessment. 2007; 11(9): .
Krantz M, Mehler P. Treating opioid dependence . Archives of Internal Medicine. 2004 ; 164(3) : 277-288. Available at: https://www.ncbi.nlm.nih.gov/pubmed/14769623 Accessed on: 2013-12-04.
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A systematic review and economic evaluation of methadone and buprenorphine for the management of opioid dependence.
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Health Technology Assessment; Vol 11: number 9. Connock et al., 2007.
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