A Preliminary Study Comparing Methadone and Buprenorphine in Patients with Chronic Pain and Coexistent Opioid Addiction

Anne M. Neumann, Richard D. Blondell, Urmo Jaanimägi, Amanda K. Giambrone, Gregory G. Homish, Jacqueline Lozano, Urszula Kowalik, Mohammadreza Azadfard

Journal of Addictive Diseases · 2013 · 93 citations · 25 references

DOIFull text

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Concepts

TL;DR

Patients with opioid addiction who receive prescription opioids for nonmalignant chronic pain face a therapeutic challenge. In a randomized trial, 54 participants with chronic pain and opioid addiction were assigned to methadone or buprenorphine/naloxone. After six months, 48 % reported a 12.8 % pain reduction, no methadone users reported illicit opioid use versus five buprenorphine users, and overall low‑dose methadone or buprenorphine/naloxone produced analgesia with no other significant differences.

Abstract

Patients with opioid addiction who receive prescription opioids for treatment of nonmalignant chronic pain present a therapeutic challenge. Fifty-four participants with chronic pain and opioid addiction were randomized to receive methadone or buprenorphine/naloxone. At the 6-month follow-up examination, 26 (48.1%) participants who remained in the study noted a 12.75% reduction in pain (P = 0.043), and no participants in the methadone group compared to 5 in the buprenorphine group reported illicit opioid use (P = 0.039). Other differences between the two conditions were not found. Long-term, low-dose methadone or buprenorphine/naloxone treatment produced analgesia in participants with chronic pain and opioid addiction.

References

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