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Therapeutics
Buprenorphine improved treatment retention in patients with heroin dependence

https://doi.org/10.1136/ebm.8.5.150

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    (2003) Lancet 361, 662. Kakko J, Svanborg KD, Kreek MJ, et al.. 1-year retention and social function after buprenorphine-assisted relapse prevention treatment for heroin dependence in Sweden: a randomised, placebo-controlled trial.. ;. :. –8.
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 QUESTION: In patients with heroin dependence, is buprenorphine added to intensive cognitive behavioural therapy effective?

    Design

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

    Setting

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

    Patients

    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.

    Intervention

    20 patients were allocated to sublingual buprenorphine, …

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    Footnotes

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

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

    • ↵* See glossary.

    • ↵† Information provided by author.