Buprenorphine versus methadone maintenance treatment in an ambulant setting: a health-related quality of life assessment
Article first published online: 7 MAY 2003
Volume 98, Issue 5, pages 693–702, May 2003
How to Cite
Giacomuzzi, S. M., Riemer, Y., Ertl, M., Kemmler, G., Rössler, H., Hinterhuber, H. and Kurz, M. (2003), Buprenorphine versus methadone maintenance treatment in an ambulant setting: a health-related quality of life assessment. Addiction, 98: 693–702. doi: 10.1046/j.1360-0443.2003.00352.x
- Issue published online: 7 MAY 2003
- Article first published online: 7 MAY 2003
- Submitted 29 May 2002; initial review completed 25 September 2002; final version accepted 23 December 2002
- maintenance treatment;
- quality of life
Background To compare the effects on quality of life (QOL) of oral methadone with sublingual buprenorphine.
Methods We performed an open-label, non-randomized, two-site (methadone–buprenorphine) study. During 6 months we assessed the quality of life status of 53 opioid-dependent patients admitted to a methadone or buprenorphine maintenance programme using the German version (Berlin Quality of Life Profile) of the Lancashire Quality of Life Profile. Physical symptoms were measured using the Opioid Withdrawal Scale. Five hundred and thirty urine screening tests were carried out randomly to detect additional consumption.
Results Sixty-seven opioid-dependent subjects (38 on methadone and 29 on buprenorphine) were enrolled in the study, and 53 completed it (30 subjects treated with buprenorphine and 23 subjects with racemic methadone). The subjects were comparable on all baseline measures. At the first follow-up (week 8), the buprenorphine-maintained group showed significantly less additional consumption of opioids (P = 0.013) compared with the methadone group. Patients retained in the buprenorphine or methadone programme (week 24) showed no significant differences in all quality of life scores. At the end of the study period, the buprenorphine-maintained group showed significantly less additional consumption of opioids (P = 0.001) and cocaine (P = 0.018) compared with the methadone group. The outcome measures for withdrawal symptoms after 24 weeks of treatment with buprenorphine showed slight advantages in stomach cramps, fatigue or tiredness, feelings of coldness and heart pounding.
Conclusions These results suggest that buprenorphine treatment is as effective as methadone regarding effects on quality of life and withdrawal symptoms. Buprenorphine has the potential to reduce the harm caused by drug abuse. Further research is needed to determine if buprenorphine is more effective than methadone in particular subgroups of patients.