| Titre : | 1-year retention and social function after buprenorphine-assisted relapse prevention treatment for heroin dependence in Sweden: a randomised, placebo-controlled trial (2003) |
| Titre original: | (Efficacité d'un traitement à la buprénorphine de 1 an, associé à un soutien social, pour prévenir la rechute d'héroïnomanes en Suéde : un essai randomisé contre placebo) |
| Auteurs : | J. KAKKO ; K. D. SVANBORG ; M. J. KREEK ; M. HEILIG |
| Type de document : | Article : Périodique |
| Dans : | Lancet (The) (Vol.361, n°9358, February 22, 2003) |
| Article en page(s) : | 662-668 |
| Note générale : | Correspondence: Maintenance buprenorphine for opioid users. Farré M., Torrens M. The Lancet, 2003, Vol. 361, n° 9372, p. 1906-1907. |
| Langues: | Anglais |
| Discipline : | TRA (Traitement et prise en charge / Treatment and care) |
| Mots-clés : |
Thésaurus TOXIBASE SUBSTITUTION ; BUPRENORPHINE ; RETENTION ; EFFICACITE ; RECHUTE ; TRAITEMENT DE MAINTENANCE ; ETUDE RANDOMISEEThésaurus Géographique SUEDE |
| Résumé : | Background: The partial opiate-receptor agonist buprenorphine has been suggested for treatment of heroin dependence, but there are few long-term and placebo-controlled studies of its effectiveness. We aimed to assess the 1-year efficacy of buprenorphine in combination with intensive psychosocial therapy for treatment of heroin dependence. Methods: 40 individuals aged older than 20 years, who met DSM-IV criteria for opiate dependence for at least 1 year, but did not fulfil Swedish legal criteria for methadone maintenance treatment were randomly allocated either to daily buprenorphine (fixed dose 16 mg sublingually for 12 months; supervised daily administration for a least 6 months, possible take-home doses thereafter) or a tapered 6 day regimen of buprenorphine, thereafter followed by placebo. All patients participated in cognitive-behavioural group therapy to prevent relapse, received weekly individual counselling sessions, and submitted thrice weekly supervised urine samples for analysis to detect illicit drug use. Our primary endpoint was 1-year retention in treatment and analysis was by intention to treat. Findings: 1-year retention in treatment was 75% and 0% in the buprenorphine and placebo groups, respectively (p=00001; risk ratio 58,7 [95% CI 7.4-467.4]). Urine screens were about 75% negative for illicit opiates, central stimulants, cannabinoids, and benzodiazepines in the patients remaining in treatment. Interpretation: The combination of buprenorphine and intensive psychosociaf treatment is safe and highly efficacious, and should be added to the treatment options available for individuals who are dependent on heroin. |
| Domaine : | Drogues illicites / Illicit drugs |
| Refs biblio. : | 30 |
| Affiliation : | Division of Psychiatry, NEUROTEC, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden |
| Numéro Toxibase : | 206790 |
| Centre Emetteur : | 02 Coordonnateur |
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