Salome Gastberger1, Markus R Baumgartner2, Michael Soyka3,4, Boris B Quednow5, Lea M Hulka6, Marcus Herdener6, Erich Seifritz7, Jochen Mutschler6,8. 1. Department of Psychiatry, Center for Addictive Disorders, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland, salomegastberger@hotmail.com. 2. Zurich Institute of Forensic Medicine, Center for Forensic Hair Analysis, University of Zurich, Zürich, Switzerland. 3. Medical Park Chiemseeblick Fachklinik für Psychosomatik, Bernau, Germany. 4. Psychiatric Hospital University of Munich, Munich, Germany. 5. Department of Psychiatry, Experimental and Clinical Pharmacopsychology, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland. 6. Department of Psychiatry, Center for Addictive Disorders, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland. 7. Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland. 8. Privatklinik Meiringen, Postfach 612, Meiringen, Switzerland.
Abstract
BACKGROUND: Among all the treatment methods developed so far, opioid agonist treatment (OAT) is the most effective therapy for opioid dependence. While methadone (MTD) is the most commonly used, fewer data are available on alternative opioid agonist. The aim of this study was to assess the efficacy of buprenorphine (BUP) and slow-released morphine compared to MTD with regard to the reduction of concomitant heroin and cocaine use. METHODS: This cross-sectional study included 105 patients receiving MTD, BUP, or slow-release morphine as opioid agonist therapy at the Psychiatric Hospital of Zurich. Illicit drug use was assessed using a retrospective 3-month hair toxicology analysis to quantify concentrations of heroin degradation products and metabolites, as well as cocaine and cocaine metabolites. We have also collected self-reports, but in the data of the study, only the results of the hair analysis were considered. RESULTS: BUP-treated patients showed lower rates of illicit opiate consumption in comparison to the group treated with MTD or slow-released morphine (p < 0.05). The proportion of heroin-positive hair samples associated with slow-release morphine treatment was similar to the proportion associated with MTD treatment. Neither the MTD vs. slow-released morphine groups nor the BUP vs. MTD groups showed significant differences in the number of patients consuming cocaine although patients in the BUP group had significantly lower concentrations of cocaine in hair testing compared to the patients in the MTD group. Prevalence of cocaine consumption was also significantly lower in the BUP group compared to patients in the slow-release morphine group (p < 0.05). CONCLUSION: This study suggests that BUP OAT is associated with reduced additional opiate co-use.
BACKGROUND: Among all the treatment methods developed so far, opioid agonist treatment (OAT) is the most effective therapy for opioid dependence. While methadone (MTD) is the most commonly used, fewer data are available on alternative opioid agonist. The aim of this study was to assess the efficacy of buprenorphine (BUP) and slow-released morphine compared to MTD with regard to the reduction of concomitant heroin and cocaine use. METHODS: This cross-sectional study included 105 patients receiving MTD, BUP, or slow-release morphine as opioid agonist therapy at the Psychiatric Hospital of Zurich. Illicit drug use was assessed using a retrospective 3-month hair toxicology analysis to quantify concentrations of heroin degradation products and metabolites, as well as cocaine and cocaine metabolites. We have also collected self-reports, but in the data of the study, only the results of the hair analysis were considered. RESULTS: BUP-treated patients showed lower rates of illicit opiate consumption in comparison to the group treated with MTD or slow-released morphine (p < 0.05). The proportion of heroin-positive hair samples associated with slow-release morphine treatment was similar to the proportion associated with MTD treatment. Neither the MTD vs. slow-released morphine groups nor the BUP vs. MTD groups showed significant differences in the number of patients consuming cocaine although patients in the BUP group had significantly lower concentrations of cocaine in hair testing compared to the patients in the MTD group. Prevalence of cocaine consumption was also significantly lower in the BUP group compared to patients in the slow-release morphine group (p < 0.05). CONCLUSION: This study suggests that BUP OAT is associated with reduced additional opiate co-use.
Authors: Leigh V Panlilio; Samuel W Stull; Jeremiah W Bertz; Albert J Burgess-Hull; Stephanie T Lanza; Brenda L Curtis; Karran A Phillips; David H Epstein; Kenzie L Preston Journal: Psychopharmacology (Berl) Date: 2021-02-08 Impact factor: 4.415
Authors: William Oles; Marcus Alexander; Navin Kumar; Benjamin Howell; Patrick G O'Connor; Lynn M Madden; Declan T Barry Journal: BMC Psychiatry Date: 2022-04-02 Impact factor: 3.630