SEP 18, 2015 4:15 PM PDT

Risks of Methadone in Treatment for Opioid Dependence

WRITTEN BY: Ilene Schneider
When patients begin treatment for dependence on opioids, they are five times as likely to die in the first four weeks when they are given the most commonly used treatment, methadone, rather than with an alternative treatment, buprenorphine, according to a study by researchers at the University of Bristol, King’s College London and the National Drug and Alcohol Research Centre at UNSW in Australia
Methadone treatment can be risky in first month. 
The study, published in the Lancet Psychiatry, and reported in Drug Discovery & Development, reviewed the records of 32,033 patients who had started treatment with methadone or buprenorphine between 2001 and 2010. Those who began treatment with buprenorphine were less likely to die from any cause, including drug-related causes, in the first four weeks of treatment. Nonetheless, after four weeks there was little difference in risk of death between methadone and buprenorphine.
 
About 50,000 Australians (and more than 100,000 people in the UK) currently receive opioid pharmacotherapy treatment for dependence on heroin or other opioids. About two-thirds of these people are being treated with methadone and the remainder on buprenorphine, according to statistics from the Australian Institute of Health and Welfare. Buprenorphine is thought to be safer, because it is less likely to cause respiratory depression (breathing problems), but patients on buprenorphine are more likely to drop out of treatment than with methadone. Both of these treatments are endorsed by the World Health Organization.
 
According to Dr. Jo Kimber, one of the study’s lead authors and a researcher at the National Drug and Alcohol Research Centre UNSW and King’s College London, “Clinicians providing opioid substitution treatment face an important dilemma: which is more likely to reduce patient risk, buprenorphine or methadone? Buprenorphine is argued to have a superior safety profile to methadone but a higher drop-out rate. Our data suggest, at least at the beginning of treatment for heroin use, that buprenorphine has clear benefits over methadone in reducing mortality risk.”
 
As Professor Louisa Degenhardt at the National Drug and Alcohol Research Centre and one of the study’s authors, explained, “The findings support a stepped approach to treatment. Opioid substitution therapy is proven to be a cost effective and safe treatment for opioid dependence. It not only reduces risk of death but also involvement in crime and imprisonment.”
 
Professor Matthew Hickman, professor of public health and epidemiology at the University of Bristol, concluded, “These findings are of importance to GPs treating patients with drug-dependency problems, one way to reduce risks might be to commence treatment on buprenorphine for the first four weeks and then switch to methadone at a later stage without increased risk.”
About the Author
  • Ilene Schneider is the owner of Schneider the Writer, a firm that provides communications for health care, high technology and service enterprises. Her specialties include public relations, media relations, advertising, journalistic writing, editing, grant writing and corporate creativity consulting services. Prior to starting her own business in 1985, Ilene was editor of the Cleveland edition of TV Guide, associate editor of School Product News (Penton Publishing) and senior public relations representative at Beckman Instruments, Inc. She was profiled in a book, How to Open and Operate a Home-Based Writing Business and listed in Who's Who of American Women, Who's Who in Advertising and Who's Who in Media and Communications. She was the recipient of the Women in Communications, Inc. Clarion Award in advertising. A graduate of the University of Pennsylvania, Ilene and her family have lived in Irvine, California, since 1978.
You May Also Like
JUL 06, 2021
Clinical & Molecular DX
Undiagnosed Dementia Much More Prevalent Than Previously Thought
JUL 06, 2021
Undiagnosed Dementia Much More Prevalent Than Previously Thought
An analysis of data from the Health and Retirement Study has yielded a startling revelation: 91 percent of people experi ...
JUL 16, 2021
Neuroscience
From Thought to Text: A Neural Interface can Type the Sentences You Think
JUL 16, 2021
From Thought to Text: A Neural Interface can Type the Sentences You Think
Researchers create neural interface to decode thought into text
JUL 20, 2021
Neuroscience
How much sleep do you need? It's all in the genes.
JUL 20, 2021
How much sleep do you need? It's all in the genes.
Genetics holds crucial information about how much sleep we need
AUG 01, 2021
Drug Discovery & Development
Berry Compound Reverses Parkinson's in Mice
AUG 01, 2021
Berry Compound Reverses Parkinson's in Mice
A naturally-occurring compound called farnesol found in berries and other fruits prevents and reverses Parkinson's-a ...
SEP 07, 2021
Neuroscience
Researchers Harness the Power of Machine Learning to Facilitate Drug Repurposing
SEP 07, 2021
Researchers Harness the Power of Machine Learning to Facilitate Drug Repurposing
Using machine learning and massive data sets from patients, researchers identify drug and drug combinations that could b ...
SEP 14, 2021
Health & Medicine
The New Social Darwinists: It's All About Survival at Any Cost
SEP 14, 2021
The New Social Darwinists: It's All About Survival at Any Cost
Researchers have found that people who perceive social relations in general Darwinian terms tend toward various personal ...
Loading Comments...