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Buprenorphine versus dihydrocodeine for opiate detoxification in primary care: a randomised controlled trial

Wright, N.M.J., Sheard, L., Tompkins, C.N.E., Adams, C.E., Allgar, V.L. and Oldham, N.S. (2007) Buprenorphine versus dihydrocodeine for opiate detoxification in primary care: a randomised controlled trial. BMC Family Practice, 8 (3). ISSN 1471-2296

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Abstract

Background

Many drug users present to primary care requesting detoxification from illicit opiates. There are a number of detoxification agents but no recommended drug of choice. The purpose of this study is to compare buprenorphine with dihydrocodeine for detoxification from illicit opiates in primary care.

Methods

Open label randomised controlled trial in NHS Primary Care (General Practices), Leeds, UK. Sixty consenting adults using illicit opiates received either daily sublingual buprenorphine or daily oral dihydrocodeine. Reducing regimens for both interventions were at the discretion of prescribing doctor within a standard regimen of not more than 15 days. Primary outcome was abstinence from illicit opiates at final prescription as indicated by a urine sample. Secondary outcomes during detoxification period and at three and six months post detoxification were recorded.

Results

Only 23% completed the prescribed course of detoxification medication and gave a urine sample on collection of their final prescription. Risk of non-completion of detoxification was reduced if allocated buprenorphine (68% vs 88%, RR 0.58 CI 0.35–0.96, p = 0.065). A higher proportion of people allocated to buprenorphine provided a clean urine sample compared with those who received dihydrocodeine (21% vs 3%, RR 2.06 CI 1.33–3.21, p = 0.028). People allocated to buprenorphine had fewer visits to professional carers during detoxification and more were abstinent at three months (10 vs 4, RR 1.55 CI 0.96–2.52) and six months post detoxification (7 vs 3, RR 1.45 CI 0.84–2.49).

Conclusion

Informative randomised trials evaluating routine care within the primary care setting are possible amongst drug using populations. This small study generates unique data on commonly used treatment regimens.

Item Type: Article
Copyright, Publisher and Additional Information: © 2007 Wright et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Institution: The University of Leeds
Academic Units: The University of Leeds > University of Leeds Research Centres and Institutes > Centre for Research in Primary Care (Leeds)
The University of Leeds > Faculty of Medicine and Health (Leeds) > Institute of Health Sciences (Leeds) > Academic Unit of Psychiatry and Behavioural Sciences (Leeds)
Depositing User: Sherpa Assistant
Date Deposited: 26 Jan 2007
Last Modified: 05 Jun 2014 09:07
Published Version: http://www.biomedcentral.com/1471-2296/8/3
Status: Published
Publisher: BioMed Central
Refereed: Yes
Identification Number: 10.1186/1471-2296-8-3
URI: http://eprints.whiterose.ac.uk/id/eprint/1927

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