2024-11-11 07:00:00
The opioid addiction would affect nearly 180,000 people in France. If buprenorphine represents a reference molecule in the treatment of such dependence, a study carried out by Canadian researchers suggests that the risk of interruption of substitution treatment of opioid addictions turns out lower with methadone. Focus on the conclusions of this unprecedented study.
Opioids, dangerous substances
Opioids are a group of psychotropic substances used as level II and III analgesics in the treatment of severe pain. These substances interact directly with opioid receptors and exhibit effects similar to those of opium.
But these substances (morphine, buprenorphine, fentanyl, hydromorphone, oxycodone) are also hard drugs, used by drug addicts in whom they cause a significant state of dependence. In France, the number of people addicted to opiates is estimated at 180,000. And the risks involved are serious and numerous, endangering the life of the person in the event of an overdose.
Read also – Soon a secure prescription for tramadol and codeine
What treatment should be preferred for opioid use disorder?
Regarding the management of such dependency, buprenorphine represents a reference molecule in substitution treatment addiction to oral opioids. It is nevertheless subject to abuse and poor compliance by patients in the withdrawal phase.
Internationally, recommendations for opioid agonists in the treatment of opioid use disorder (OUD) are disparate. The level of evidence relating to the effectiveness of the different therapeutic options appears to be low.
To know! Substance use disorder refers to pathological behavior where the patient continues to use a substance despite considerable problems (personal, family, socio-professional, etc.) linked to its use.
In this context, Canadian researchers have undertaken to shed light on the subject by comparing methadone to the buprenorphine/naloxone duo in the treatment of opioid use disorder (OUD).
Read also – An implant against opioid addiction
Better compliance with methadone treatment
This retrospective study was therefore based on data from a panel of nearly 31,000 patients who started a first treatment for opioid use disorder between 2010 and 2020. This was the buprenorphine/naloxone duo for 39 % of these patients. The objective of such a study? Measure compliance with treatment and patient mortality at 2 years.
After analyzing the data, the researchers were able to note a significantly greater therapeutic benefit for methadone with :
A better treatment compliance for patients on methadone (66 days on median compared to 30 days for patients on buprenorphine/naloxone before an interruption of more than 5 days). A risk of discontinuation of 81.5% for methadone compared to 88.8% for buprenorphine/naloxone. risk of interruption at optimal treatment doses of 30.7% for methadone versus 42.1% for buprenorphine/naloxone.
Regarding mortality risk, the researchers found:
A low risk of mortality for both treatments among opioid users starting their first treatment (0.08% for buprenorphine/naloxone and 0.13% for methadone). A low risk of mortality among all patients whether it is their first treatment for opioid use disorder (0.08%) or not (0.09%).
Note that the consistency of these results was maintained after taking into account a more powerful molecule, fentanyl in the use of opioids.
To know! Fentanyl has an analgesic effect approximately 100 times more powerful than that of morphine. Its main therapeutic effects are analgesic and sedative.
Building on these results published in the journal Jama, the authors of this study therefore invite review international recommendations relating to the treatment of opioid use disorder to promote better patient compliance.
Read also – Stopping opioid analgesics, what impact on suicide risk?
Sources
– Treatment of opioid dependence: better compliance with methadone. infectiologie.lequotidiendumedecin.fr. Accessed October 27, 2024.
– Opioid dependence (substitution treatment). . www.vidal.fr. Accessed October 27, 2024.
– Diagnosis of opioid use disorder. High Health Authority. . www.has-sante.fr. Accessed October 27, 2024.
Written by Déborah L.
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#treat #opioid #addiction #methadone
**Interview with Dr. Marie Lefevre, Addiction Specialist**
**Interviewer:** Good morning, Dr. Lefevre. Thank you for joining us today to discuss the recent findings from the Canadian study on opioid addiction treatment.
**Dr. Lefevre:** Good morning! Thank you for having me.
**Interviewer:** The study indicates that nearly 180,000 people in France are affected by opioid addiction. Could you explain the significance of this number in the context of public health?
**Dr. Lefevre:** Absolutely. This statistic highlights a pressing public health crisis. Opioid addiction not only impacts the individuals affected but also poses broader social and economic challenges, including healthcare costs, loss of productivity, and strain on social services. The scale of the issue calls for urgent and effective treatment strategies.
**Interviewer:** The study found that methadone treatment leads to better compliance compared to buprenorphine/naloxone. What factors contribute to this difference in treatment adherence?
**Dr. Lefevre:** Several factors may influence treatment adherence. Methadone can offer more stable and sustained relief from withdrawal symptoms, which might encourage patients to stick with it. Additionally, the more frequent dosing schedule of buprenorphine/naloxone may lead to higher rates of missed doses due to lifestyle factors or difficulties in managing the treatment regimen.
**Interviewer:** The results showed a significantly lower risk of treatment interruption with methadone. Why is minimizing treatment interruption crucial in opioid dependence recovery?
**Dr. Lefevre:** Minimizing interruption is vital as discontinuing treatment can lead to relapse and increased risk of overdose. Continuous treatment helps stabilize individuals, mitigate cravings, and prevent the associated harms of addiction. It’s critical for recovery that patients can remain in treatment consistently.
**Interviewer:** The findings suggest a low risk of mortality associated with both treatments. How can this information influence the choice of treatment for healthcare providers?
**Dr. Lefevre:** Knowing that both treatments have low mortality risks is promising. However, it emphasizes the need for personalized treatment plans. Providers must consider individual patient needs, histories, and the dynamics of their addiction when recommending a treatment option. Methadone may be more suitable for those who have struggled with compliance in the past.
**Interviewer:** As an addiction specialist, what do you think should be the next steps for addressing opioid addiction in France?
**Dr. Lefevre:** We need a multifaceted approach: enhancing access to effective treatments like methadone, increasing public awareness about addiction, and promoting harm reduction strategies. Additionally, ongoing research is crucial to continually refine our understanding and approaches to treating opioid use disorder.
**Interviewer:** Thank you, Dr. Lefevre, for sharing your insights on this critical issue.
**Dr. Lefevre:** Thank you for having me. It’s vital we keep the conversation going about opioid addiction and treatment options.
