Mortality risk of opioid substitution therapy with methadone versus buprenorphine
Opioid-dependent patients are five times more likely to die in the first four weeks of treatment if they are prescribed methadone rather than the alternative treatment, buprenorphine, a new NDARC study has shown.
The study, published in the journal Lancet Psychiatry, reviewed the records of 32,033 patients who started treatment with methadone, the most commonly used treatment, or buprenorphine between 2001 and 2010.
Patients who started treatment with buprenorphine were less likely to die from any cause, including drug related causes, in the first four weeks of treatment. However, after four weeks there was little difference in risk of death between methadone and buprenorphine.
Buprenorphine is considered to be safer as it is less likely to cause respiratory depression (problems breathing), but patients are more likely to drop out of treatment than with methadone. Both treatments are endorsed by the World Health Organization.