Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2011 Dec;61(593):e772-80.
doi: 10.3399/bjgp11X613106.

Comparison of methadone and buprenorphine for opiate detoxification (LEEDS trial): a randomised controlled trial

Nat M J Wright  1 , Laura Sheard, Clive E Adams, Bruno J Rushforth, Wendy Harrison, Nicole Bound, Roger Hart, Charlotte N E Tompkins
Affiliations
Randomized Controlled Trial

Comparison of methadone and buprenorphine for opiate detoxification (LEEDS trial): a randomised controlled trial

Nat M J Wright et al. Br J Gen Pract. 2011 Dec.

Abstract

Background: Many opiate users require prescribed medication to help them achieve abstinence, commonly taking the form of a detoxification regime. In UK prisons, drug users are nearly universally treated for their opiate use by primary care clinicians, and once released access GP services where 40% of practices now treat drug users. There is a paucity of evidence evaluating methadone and buprenorphine (the two most commonly prescribed agents in the UK) for opiate detoxification.

Aim: To evaluate whether buprenorphine or methadone help to achieve drug abstinence at completion of a reducing regimen for heroin users presenting to UK prison health care for detoxification.

Design: Open-label, pragmatic, randomised controlled trial in three prison primary healthcare departments in the north of England.

Method: Prisoners (n = 306) using illicit opiates were recruited and given daily sublingual buprenorphine or oral methadone, in the context of routine care, over a standard reduced regimen of not more than 20 days. The primary outcome measure was abstinence from illicit opiates at 8 days post detoxification, as indicated by urine test (self-report/clinical notes where urine sample was not feasible). Secondary outcomes were also recorded.

Results: Abstinence was ascertained for 73.7% at 8 days post detoxification (urine sample = 52.6%, self report = 15.2%, clinical notes = 5.9%). There was no statistically significant difference in the odds of achieving abstinence between methadone and buprenorphine (odds ratio [OR] = 1.69; 95% confidence interval [CI] = 0.81 to 3.51; P = 0.163). Abstinence was associated solely with whether or not the participant was still in prison at that time (15.22 times the odds; 95% CI = 4.19 to 55.28). The strongest association for lasting abstinence was abstinence at an earlier time point.

Conclusion: There is equal clinical effectiveness between methadone and buprenorphine in achieving abstinence from opiates at 8 days post detoxification within prison.

PubMed Disclaimer

Figures

Figure 1
Figure 1
CONSORT diagram.
See this image and copyright information in PMC

Comment in

References

    1. National Offender Management Service. Strategy for the management and treatment of problematic drug users within the correctional facilities. London: National Offender Management Service; 2005.
    1. Department of Health and the Devolved Administrations. Drug misuse and dependence: UK guidelines on clinical management. London: Department of Health and the Devolved Administrations; 2007.
    1. Department of Health. Clinical management of drug dependence in the adult prison setting. London: Department of Health; 2006.
    1. Mattick R, Kimber J, Breen C, Davoli M. Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence. Cochrane Database Syst Rev. 2008;(2) CD002207. - PubMed
    1. Stallwitz A, Stover H. The impact of substitution treatment in prisons — a literature review. Int J Drug Policy. 2007;18(6):464–474. - PubMed

Publication types

Associated data