Buprenorphine has become of increasing interest to be an alternative to methadone in the treatment of heroin addicts. The aim of the paper is to review, from a clinical perspective, the current status of what is known about the pharmacology of buprenorphine, with a particular emphasis on the issues of maintenance therapy in heroin addiction. A systematic review of published follow-up data, from...

BACKGROUND Opiate dependence is a major health and social issue in many countries. A mainstay of therapy has been methadone maintenance treatment, but other treatments, particularly buprenorphine, are increasingly being considered. AIM To conduct a systematic review to synthesise and critically appraise the evidence on the effectiveness of community maintenance programmes with methadone or bu...

OBJECTIVES To explore HIV-infected patients' attitudes about buprenorphine treatment in office-based and opioid treatment program (OTP) settings. METHODS We conducted in-depth qualitative interviews with 29 patients with co-existing HIV infection and opioid dependence seeking buprenorphine maintenance therapy in office-based and OTP settings. We used thematic analysis of transcribed audioreco...

BACKGROUND Methadone maintenance therapy is a treatment of choice for opiate addiction. Understanding opiate dependents' experiences of patients' treatment is a key to continue the treatment and can provide help to revise the standards of methadone centers and improve the quality of treatment. This study aimed to describe the essence and structure of opiate dependents' experiences with methadon...

Patient satisfaction is an individual's cognitive evaluation of, and emotional reaction to, his or her health-care experience. This concept is increasing in importance as survey data are being used by health-care facilities for self-assessment, accreditation requirements, and compensation formulas. High patient satisfaction is associated with increased market share, financial gains, decreased m...

Study selection Studies were selected using Cochrane Collaboration criteria. Randomised controlled trials or controlled clinical trials published in English, German or Italian between 1973 and February 2002 were eligible if they compared naltrexone maintenance treatment after opiate detoxification with placebo, pharmacological or behavioural interventions. The 11 studies included were heterogen...

OBJECTIVE Physicians may prescribe buprenorphine for opioid agonist maintenance treatment outside of narcotic treatment programs, but treatment guidelines for patients with co-occurring cocaine and opioid dependence are not available. This study compares effects of buprenorphine and methadone and evaluates the efficacy of combining contingency management with maintenance treatment for patients ...

BACKGROUND The brief version of World Health Organization Quality of Life assessment (WHOQOL-BREF), a useful outcome measure for clinical decision making, has been evaluated using classical test theory (CTT) for psychometric properties on heroin-dependent patients. However, CTT has a major disadvantage of invalid summated score, and using Rasch models can overcome the shortcoming. The purpose o...

Despite proven clinical utility, buprenorphine has not been used widely for the treatment of chronic pain. Questions about "ceiling effect" or bell-shaped curve observed for analgesia in preclinical studies and potential withdrawal issues on combining with marketed μ-agonists continue to hinder progress in expanding full potential of buprenorphine in the treatment of cancer and noncancer pain. ...

OBJECTIVE To prospectively assess if opiate antagonist treatment or the opiate-free status could reverse opiate-related vasculopathy. DESIGN Longitudinal Open Observational, Serial 'N of One', over 6.5 years under various treatment conditions: opiate dependence, naltrexone and opiate-free. SETTING Primary care, Australia. PARTICIPANTS 20 opiate-dependent patients (16 males: 16 cases of bu...