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Adding buprenorphine implants to counselling reduces opioid use over 6 months in opioid-dependent adults

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Question

Question

Can buprenorphine implants effectively treat opioid dependence?

Patients

163 adults (aged 18–65) with current DSM-IV opioid dependence. Exclusions: AIDS, current dependence on psychoactive substances other than opioids or nicotine, current pain diagnosis that required opioid treatment, current use of non-prescribed benzodiazepines or receipt of medication treatment for opioid dependence in the past 90 days.

Setting

Six academic, three Veterans Affairs and nine non-profit community addiction treatment centres, USA; April 2007 to June 2008.

Intervention

Subdermal buprenorphine or placebo implants for 6 months (four implants used, each buprenorphine implant 80 mg). Prior to randomisation all participants received sublingual buprenorphine–naloxone induction for at least 3 consecutive days. Additional supervised use of sublingual buprenorphine–naloxone tablets was permitted in both groups if withdrawal symptoms necessitated intervention. All participants received individual drug counselling: two sessions per week during weeks 1–12, then weekly thereafter. Failure to attend six consecutive sessions resulted in withdrawal from the study.

Outcomes

Primary: percentage of urine samples negative for illicit opioids for each participant during weeks …

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