In England and Wales, estimates suggest around 250,000 people have serious drug problems such as dependency, that cause considerable harm to themselves and others, and give rise to high social and economic costs.1 The number of people receiving specialist treatment for drug problems has increased greatly in recent years.2 Many people dependent on opioids will require opioid substitution treatment at some time. This may involve long-term maintenance to reduce use of illicit drugs, and/or short-term detoxification to stop such use completely. Standard management involves methadone maintenance therapy.3 Buprenorphine (Subutex – Schering-Plough) is also licensed for the management of patients with opioid dependence.4 Here we review the evidence for the use of buprenorphine compared with methadone for opioid dependence.
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