Controlled, randomized trial in maintenance treatment of intravenous buprenorphine dependence with naltrexone, methadone or buprenorphine: a novel study

Aims To test the effect of a 50-mg day(-1) dose of naltrexone in the maintenance treatment of intravenous-buprenorphine dependence in comparison with a 50- mg day(-1) dose of methadone and also a 5-mg day(-1) dose of buprenorphine over a 24-week treatment period. Participants Two hundred and four intravenous-buprenorphine-dependent patients who met the DSM-IV criteria for opioid dependence were randomized to three equal groups and were treated in a clinic in Iran where they were also offered a weekly 0.5-h counselling session, in 2002. Findings The mean age was 31.2 years (range 17 - 53). The majority [63.2%] was between 20 and 34 years of age. The educational level of most of them [55.4%] was between 6 and 12 years of study. Completion rates by groups were 83.8% for the 50-mg dose methadone group, 58.8% for the 5- mg dose buprenorphine group and 20.6% for the 50-mg dose naltrexone group (P = 0.000). Retention in the 50-mg methadone group was significantly better than in the 5- mg dose buprenorphine group ( P = 0.001) and the 50-mg dose naltrexone group (P = 0.000). Retention in the 5-mg buprenorphine group was significantly better than in the 50-mg naltrexone dose group (P = 0.000). Conclusions Evaluation of the Iranian experience on this subject may be useful for other countries.