| Titre : | Extended vs short-term buprenorphine-naloxone for treatment of opioid-addicted youth: a randomized trial (2008) |
| Auteurs : | G. E. WOODY ; S. A. POOLE ; G. SUBRAMANIAM ; DUGOSH K. ; M. BOGENSCHUTZ ; P. ABBOTT ; A. A. PATKAR ; PUBLICKER M. ; MCCAIN K. ; J. SHARPE POTTER ; R. FORMAN ; VETTER V. ; L. McNICHOLAS ; J. BLAINE ; K. G. LYNCH ; P. J. FUDALA |
| Type de document : | Article : Périodique |
| Dans : | Journal of the American Medical Association (Vol.300, n°17, November 5, 2008) |
| Article en page(s) : | 2003-2011 |
| Note générale : |
Editorial: "Treatment of adolescent opioid dependence: No quick fix", D.A. Fiellin, JAMA 2008;300(17):2057-2059.
Correction : |
| Langues: | Anglais |
| Discipline : | TRA (Traitement et prise en charge / Treatment and care) |
| Mots-clés : |
Thésaurus mots-clés ETUDE RANDOMISEE ; JEUNE ; TRAITEMENT DE MAINTENANCE ; BUPRENORPHINE ; NALOXONE ; OBSERVANCE DU TRAITEMENT ; EFFICACITE ; OPIACES ; ADOLESCENTThésaurus géographique ETATS-UNIS |
| Résumé : |
Context: The usual treatment for opioid-addicted youth is detoxification and counseling. Extended medication-assisted therapy may be more helpful.
Objective: To evaluate the efficacy of continuing buprenorphine-naloxone for 12 weeks vs detoxification for opioid-addicted youth. Design, Setting, and Patients: Clinical trial at 6 community programs from July 2003 to December 2006 including 152 patients aged 15 to 21 years who were randomized to 12 weeks of buprenorphine-naloxone or a 14-day taper (detox). Interventions: Patients in the 12-week buprenorphine-naloxone group were prescribed up to 24 mg per day for 9 weeks and then tapered to week 12; patients in the detox group were prescribed up to 14 mg per day and then tapered to day 14. All were offered weekly individual and group counseling. Main Outcome Measure: Opioid-positive urine test result at weeks 4, 8, and 12. Results: The number of patients younger than 18 years was too small to analyze separately, but overall, patients in the detox group had higher proportions of opioid-positive urine test results at weeks 4 and 8 but not at week 12 ({chi2}2 = 4.93, P = .09). At week 4, 59 detox patients had positive results (61%; 95% confidence interval [CI] = 47%-75%) vs 58 12-week buprenorphine-naloxone patients (26%; 95% CI = 14%-38%). At week 8, 53 detox patients had positive results (54%; 95% CI = 38%-70%) vs 52 12-week buprenorphine-naloxone patients (23%; 95% CI = 11%-35%). At week 12, 53 detox patients had positive results (51%; 95% CI = 35%-67%) vs 49 12-week buprenorphine-naloxone patients (43%; 95% CI = 29%-57%). By week 12, 16 of 78 detox patients (20.5%) remained in treatment vs 52 of 74 12-week buprenorphine-naloxone patients (70%; {chi2}1 = 32.90, P Conclusions: Continuing treatment with buprenorphine-naloxone improved outcome compared with short-term detoxification. Further research is necessary to assess the efficacy and safety of longer-term treatment with buprenorphine for young individuals with opioid dependence. Trial Registration clinicaltrials.gov Identifier: NCT00078130. (Author' s abstract) |
| Domaine : | Drogues illicites / Illicit drugs |
| Refs biblio. : | 36 |
| Affiliation : | USA |
| Centre Emetteur : | 13 OFDT |
| Lien : | http://dx.doi.org/10.1001/jama.2008.574 |
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