TY - JOUR T1 - Comparison of methadone and buprenorphine for opiate detoxification (LEEDS trial): a randomised controlled trial JF - British Journal of General Practice JO - Br J Gen Pract SP - e772 LP - e780 DO - 10.3399/bjgp11X613106 VL - 61 IS - 593 AU - Nat MJ Wright AU - Laura Sheard AU - Clive E Adams AU - Bruno J Rushforth AU - Wendy Harrison AU - Nicole Bound AU - Roger Hart AU - Charlotte NE Tompkins Y1 - 2011/12/01 UR - http://bjgp.org/content/61/593/e772.abstract N2 - Background Many opiate users require prescribed medication to help them achieve abstinence, commonly taking the form of a detoxification regime. In UK prisons, drug users are nearly universally treated for their opiate use by primary care clinicians, and once released access GP services where 40% of practices now treat drug users. There is a paucity of evidence evaluating methadone and buprenorphine (the two most commonly prescribed agents in the UK) for opiate detoxification.Aim To evaluate whether buprenorphine or methadone help to achieve drug abstinence at completion of a reducing regimen for heroin users presenting to UK prison health care for detoxification.Design Open-label, pragmatic, randomised controlled trial in three prison primary healthcare departments in the north of England.Method Prisoners (n = 306) using illicit opiates were recruited and given daily sublingual buprenorphine or oral methadone, in the context of routine care, over a standard reduced regimen of not more than 20 days. The primary outcome measure was abstinence from illicit opiates at 8 days post detoxification, as indicated by urine test (self-report/clinical notes where urine sample was not feasible). Secondary outcomes were also recorded.Results Abstinence was ascertained for 73.7% at 8 days post detoxification (urine sample = 52.6%, self report = 15.2%, clinical notes = 5.9%). There was no statistically significant difference in the odds of achieving abstinence between methadone and buprenorphine (odds ratio [OR] = 1.69; 95% confidence interval [CI] = 0.81 to 3.51; P = 0.163). Abstinence was associated solely with whether or not the participant was still in prison at that time (15.22 times the odds; 95% CI = 4.19 to 55.28). The strongest association for lasting abstinence was abstinence at an earlier time point.Conclusion There is equal clinical effectiveness between methadone and buprenorphine in achieving abstinence from opiates at 8 days post detoxification within prison. ER -