Historique
Article de Périodique
1-year retention and social function after buprenorphine-assisted relapse prevention treatment for heroin dependence in Sweden: a randomised, placebo-controlled trial (2003)
(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)
Auteur(s) :
J. KAKKO ;
K. D. SVANBORG ;
M. J. KREEK ;
M. HEILIG
Article en page(s) :
662-668
Refs biblio. :
30
Domaine :
Drogues illicites / Illicit drugs
Langue(s) :
Anglais
Thésaurus mots-clés
SUBSTITUTION
;
BUPRENORPHINE
;
RETENTION
;
EFFICACITE
;
RECHUTE
;
TRAITEMENT DE MAINTENANCE
;
ETUDE RANDOMISEE
Thésaurus géographique
SUEDE
Note générale :
Correspondence:
Maintenance buprenorphine for opioid users. Farré M., Torrens M. The Lancet, 2003, Vol. 361, n° 9372, p. 1906-1907.
Maintenance buprenorphine for opioid users. Farré M., Torrens M. The Lancet, 2003, Vol. 361, n° 9372, p. 1906-1907.
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.
Affiliation :
Division of Psychiatry, NEUROTEC, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden