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Buprenorphine improved treatment retention in patients with heroin dependence

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 QUESTION: In patients with heroin dependence, is buprenorphine added to intensive cognitive behavioural therapy effective?


Randomised (allocation concealed*), blinded {patients, clinicians and data collectors},* placebo controlled trial with follow up at 1 year.


The chemical dependence unit of an addiction centre in Stockholm, Sweden.


40 patients ≥20 years of age (mean age 30 y, 73% men) with an opiate dependence who were seeking admission for medically assisted heroin withdrawal and had ≥1 year of heroin dependence (DSM-IV criteria). Exclusion criteria were eligibility for methadone maintenance treatment in Sweden (≥4 y of multiple daily heroin use objectively documented in hospital records and ≥3 unsuccessful attempts in abstinence oriented treatment); codependence on alcohol, amphetamines, cannabinoids, or benzodiazepines; neurological disorders; dementia; cognitive impairment; psychosis; or other psychiatric disorder (unless the patient was stable and on treatment not contraindicated to buprenorphine). All patients were included in the analysis.


20 patients were allocated to sublingual buprenorphine, …

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  • Sources of funding: Swedish Medical Council and US National Institutes of Health.

  • For correspondence: Dr M Heilig, Karolinska Institute, Stockholm, Sweden. Markus.heilig{at}

  • * See glossary.

  • Information provided by author.