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

TLDR

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.