Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

199 questions · 208 findings · 27 reviews · Drugs and Alcohol

No studies found 5 · 2.4%GRADE not reported 6 · 2.9%Very low 45 · 21.6%Low 79 · 38%Moderate 59 · 28.4%High 14 · 6.7%

Rapid vs slow taper of buprenorphine dose

Completion of withdrawal treatment − Outpatient · Adults or adolescents with opioid dependence

It is very uncertain whether rapid changes completion of withdrawal treatment − Outpatient compared with slow taper of buprenorphine dose (very low certainty).

1 finding from 1 review

Rapid vs slow taper of buprenorphine dose

Number abstinent at completion of dose taper − Outpatient · Adults or adolescents with opioid dependence

It is very uncertain whether rapid changes number abstinent at completion of dose taper − Outpatient compared with slow taper of buprenorphine dose (very low certainty).

1 finding from 1 review

Rapid vs slow taper of buprenorphine dose

Completion of withdrawal treatment − Inpatient · Adults or adolescents with opioid dependence

Rapid showed no clear difference in completion of withdrawal treatment − Inpatient compared with slow taper of buprenorphine dose (low certainty).

1 finding from 1 review

Intervention not reported

Adverse events ‐ Withdrawn for medical reasons: Tricyclics versus placebo · patients with depression during opioid agonist treatment for opioid dependence

The intervention leads to higher adverse events ‐ Withdrawn for medical reasons: Tricyclics versus… (high certainty).

1 finding from 1 review

Intervention not reported

Adverse events ‐ Withdrawn for medical reasons: SSRI versus placebo · patients with depression during opioid agonist treatment for opioid dependence

The intervention showed no clear difference in adverse events ‐ Withdrawn for medical reasons: SSRI versus placebo (high certainty).

1 finding from 1 review

Full opioid agonists vs different full opioid agonists or partial opioid agonists (methadone versus buprenorphine)

Illicit opioid use · pharmaceutical opioid dependent people

Full opioid agonists showed no clear difference in illicit opioid use compared with different full opioid agonists or partial opioid agonists (methadone… (moderate certainty).

3 findings from 1 review

Full or partial opioid agonist maintenance vs placebo, detoxification only or psychological treatment (buprenorphine maintenance compared to taper or treatment

Adverse events · pharmaceutical opioid dependent people

It is very uncertain whether full or partial opioid agonist maintenance changes adverse events compared with placebo, detoxification only or psychological treatment… (very low certainty).

1 finding from 1 review

Full opioid agonists vs different full opioid agonists or partial opioid agonists (methadone versus buprenorphine)

Retention [ · pharmaceutical opioid dependent people

Full opioid agonists may leads to higher retention compared with different full opioid agonists or partial opioid agonists (methadone… (low certainty).

1 finding from 1 review

Full opioid agonists vs different full opioid agonists or partial opioid agonists (methadone versus buprenorphine)

Adverse effects · pharmaceutical opioid dependent people

Full opioid agonists showed no clear difference in adverse effects compared with different full opioid agonists or partial opioid agonists (methadone… (low certainty).

1 finding from 1 review

Full or partial opioid agonist maintenance vs placebo, detoxification only or psychological treatment (buprenorphine maintenance compared to taper or treatment

Days of unsanctioned opioid use · pharmaceutical opioid dependent people

Full or partial opioid agonist maintenance showed no clear difference in days of unsanctioned opioid use (as number of days/30 or days/7) compared with placebo, detoxification only or psychological treatment… (low certainty).

1 finding from 1 review

Full or partial opioid agonist maintenance vs placebo, detoxification only or psychological treatment (buprenorphine maintenance compared to taper or treatment

Opioid use · pharmaceutical opioid dependent people

It is very uncertain whether full or partial opioid agonist maintenance changes self‐reported opioid use at treatment completion compared with placebo, detoxification only or psychological treatment… (very low certainty).

2 findings from 1 review

Full or partial opioid agonist maintenance vs placebo, detoxification only or psychological treatment (buprenorphine maintenance compared to taper or treatment

Retention in treatment · pharmaceutical opioid dependent people

Full or partial opioid agonist maintenance probably leads to higher retention: proportion of participants retained in treatment compared with placebo, detoxification only or psychological treatment… (moderate certainty).

1 finding from 1 review

Dihydrocodeine vs buprenorphine

Abstinence · individuals dependent on illicit opiates

Dihydrocodeine showed no clear difference in abstinence Assessed by urinalysis post‐detoxification compared with buprenorphine (low certainty).

3 findings from 1 review

Carbamazepine vs tricyclic antidepressants (TCAs)

Benzodiazepine discontinuation, end of intervention · adults who withdraw from chronic benzodiazepine use

Carbamazepine showed no clear difference in benzodiazepine discontinuation, end of intervention compared with tricyclic antidepressant (low certainty).

1 finding from 1 review