Question: For opioid-dependent persons, how effective is buprenorphine maintenance versus placebo or methadone maintenance for substance abuse?

Answer:

One well conducted Cochrane review of 31 RCTs found that buprenorphine is effective in the maintenance treatment of heroin dependence, suppressing illicit opioid use at doses of at least 16 mg or greater compared to placebo.  Flexibly administered buprenorphine has similar effectiveness to methadone for suppressing illicit opioid use, but flexibly administered methadone is superior to buprenorphine in retaining people in treatment.  These findings are consistent with NICE guidance which recommends that buprenorphine, using flexible dose regimens, is recommended as an option for maintenance therapy in the management of opioid dependence.

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To view the Cochrane review, click the link under Related Documents  below.

For relevant NICE guidelines, click the link under Related Links below.

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BEST Question 402.pdf