237916 Community-based addiction treatment clinical trials: Use of bup/nal vs. methadone

Tuesday, November 1, 2011: 2:50 PM

Andrew Saxon, MD , Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
Currently in the USA pharmacological treatment of opioid addiction most commonly consists of replacement therapy with either methadone or buprenorphine/naloxone (bup/nal). Several clinical trials from the NIDA Clinical Trials Network have demonstrated the effectiveness of bup/nal in a variety of treatment settings and populations. Most recently a multi-site, open label, Phase IV study randomized 1269 participants in federally licensed opioid treatment programs to receive either six months of methadone or six months of bup/nal. The primary outcomes of the study focused on parameters of liver function; 731 participants completed the study. Worsening of indices of liver health was rare and did not differ by medication condition. Participants in the bup/nal group had poorer treatment retention than did participants on methadone. Adoption of bup/nal treatment in licensed opioid treatment programs will require additional efforts towards treatment retention.

Learning Areas:
Basic medical science applied in public health
Clinical medicine applied in public health
Provision of health care to the public

Learning Objectives:
Compare the safety and retention profiles of bup/nal and methadone as seen in federally licensed opioid treatment facilities. Describe strategies to increase retention of patients who seek bup/nal treatment.

Keywords: Drug Abuse Treatment, Community Health Programs

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the co-principal investigator on the clinical trial described in the abstract. I am Director, Addictin Care Line at the VA Medical Center in Seattle, WA and have been and addiction treatment clinician scientist for many years. I have published in the scientific literature on pharmaceutical treatment of opioid addiction and have participated in numerous clinical trials with bup/naloxone.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.