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Review: buprenorphine better than α2 adrenergic agonists for managing opioid withdrawal

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How effective is buprenorphine for managing the symptoms of opioid withdrawal?


Primary outcomes were intensity of withdrawal, duration of withdrawal treatment or length of stay, adverse effects, treatment completion and completion of withdrawal. Adverse effects were defined as clinically significant signs and symptoms of opioid withdrawal (such as vomiting and diarrhoea) plus any events that were not typical components of the opioid withdrawal syndrome (such as hypotension and dry mouth).



Systematic review with meta-analysis.

Data sources:

The Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 3, 2008), MEDLINE (January 1966–July 2008), EMBASE (January 1985–2008 week 31), PsycINFO (1967–7 August 2008) and hand searches of reference lists.

Study selection and analysis:

Randomised and quasi-randomised controlled trials of buprenorphine based regimens to manage the signs and symptoms of withdrawal in people who were primarily opioid dependent. Permitted comparator interventions were different buprenorphine based interventions, reducing doses of methadone, α2 adrenergic agonists, symptomatic medications or placebo. Risk ratios (RR) were calculated for dichotomous outcomes and standardised mean differences (SMD) for continuous outcomes. Heterogeneity was assessed using the χ2 statistic, and random effects models were …

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  • Sources of funding Drug and Alcohol Services South Australia and the Commonwealth Department of Health and Ageing, Australia.


  • Competing interests JM is a paid consultant and leads teaching programmes for Reckitt Benckiser, the manufacturer of buprenorphine.

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