What do systematic reviews say?

Buprenorphine vs methadone

• Buprenorphine for managing opioid withdrawal 2017 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 82 participants
  Low

Buprenorphine vs methadone

Buprenorphine showed no clear difference in completion of withdrawal treatment compared with methadone (moderate certainty).

• Buprenorphine for managing opioid withdrawal 2017 · Cochrane Headline outcomes only
  RR 1.04 [0.91, 1.2]
  5 studies · 457 participants
  Moderate

Buprenorphine vs alpha2‐adrenergic agonists

It is very uncertain whether buprenorphine changes mean peak withdrawal score, compared with alpha2‐adrenergic agonists (very low certainty).

• Buprenorphine for managing opioid withdrawal 2017 · Cochrane Headline outcomes only
  no estimate extracted
  6 studies · 521 participants
  Very low

Buprenorphine vs alpha2‐adrenergic agonists

Buprenorphine showed no clear difference in mean overall withdrawal score, with various methods of assessment compared with alpha2‐adrenergic agonists (moderate certainty).

• Buprenorphine for managing opioid withdrawal 2017 · Cochrane Headline outcomes only
  no estimate extracted
  7 studies · 902 participants
  Moderate

Buprenorphine vs alpha2‐adrenergic agonists

Buprenorphine probably leads to higher mean days in treatment (with varying scheduled duration) compared with alpha2‐adrenergic agonists (moderate certainty).

• Buprenorphine for managing opioid withdrawal 2017 · Cochrane Headline outcomes only
  SMD 0.92 [0.57, 1.27]
  4 studies · 558 participants
  Moderate

Buprenorphine vs alpha2‐adrenergic agonists

It is very uncertain whether buprenorphine changes number experiencing adverse effects compared with alpha2‐adrenergic agonists (very low certainty).

• Buprenorphine for managing opioid withdrawal 2017 · Cochrane Headline outcomes only
  RR 0.93 [0.7, 1.26]
  3 studies · 493 participants
  Very low

Buprenorphine vs alpha2‐adrenergic agonists

Buprenorphine showed no clear difference in number with treatment stopped due to adverse effects compared with alpha2‐adrenergic agonists (low certainty).

• Buprenorphine for managing opioid withdrawal 2017 · Cochrane Headline outcomes only
  RR 0.2 [0.04, 1.15]
  3 studies · 134 participants
  Low

Buprenorphine vs alpha2‐adrenergic agonists

Buprenorphine probably leads to higher number completing withdrawal treatment compared with alpha2‐adrenergic agonists (moderate certainty).

• Buprenorphine for managing opioid withdrawal 2017 · Cochrane Headline outcomes only
  RR 1.59 [1.23, 2.06]
  11 studies · 1264 participants
  Moderate

Buprenorphine detox vs buprenorphine maintenance

Buprenorphine detox may leads to higher drop out Number of participants who dropped out from the study compared with buprenorphine maintenance (low certainty).

• Detoxification treatments for opiate dependent adolescents 2014 · Cochrane Headline outcomes only
  RR 2.67 [1.85, 3.86]
  1 study · 152 participants
  Low

Buprenorphine detox vs buprenorphine maintenance

Buprenorphine detox showed no clear difference in patients with positive urine at the end of treatment Number of… compared with buprenorphine maintenance (low certainty).

• Detoxification treatments for opiate dependent adolescents 2014 · Cochrane Headline outcomes only
  RR 1.03 [0.82, 1.28]
  1 study · 152 participants
  Low

Buprenorphine detox vs buprenorphine maintenance

Buprenorphine detox may leads to higher self‐reported use at 12 months compared with buprenorphine maintenance (low certainty).

• Detoxification treatments for opiate dependent adolescents 2014 · Cochrane Headline outcomes only
  RR 1.36 [1.05, 1.76]
  1 study · 152 participants
  Low

Buprenorphine detox vs buprenorphine maintenance

Buprenorphine detox showed no clear difference in enrolment in addiction treatment at 12 month compared with buprenorphine maintenance (low certainty).

• Detoxification treatments for opiate dependent adolescents 2014 · Cochrane Headline outcomes only
  RR 0.75 [0.53, 1.07]
  1 study · 152 participants
  Low

Buprenorphine vs clonidine

Buprenorphine showed no clear difference in drop out Number of participants who did not complete the… compared with clonidine (moderate certainty).

• Detoxification treatments for opiate dependent adolescents 2014 · Cochrane Headline outcomes only
  RR 0.45 [0.2, 1.04]
  1 study · 36 participants
  Moderate

Buprenorphine vs clonidine

• Detoxification treatments for opiate dependent adolescents 2014 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 32 participants
  Moderate

Buprenorphine vs clonidine

Buprenorphine probably leads to higher initiation of naltrexone treatment Number of participants initiating… compared with clonidine (moderate certainty).

• Detoxification treatments for opiate dependent adolescents 2014 · Cochrane Headline outcomes only
  RR 11 [1.58, 76.55]
  1 study · 36 participants
  Moderate

Buprenorphine maintenance vs buprenorphine detoxification

Buprenorphine maintenance may leads to lower drop‐outs Number of participants who did not complete the study compared with buprenorphine detoxification (low certainty).

• Maintenance treatments for opiate ‐dependent adolescents 2014 · Cochrane Headline outcomes only
  RR 0.37 [0.26, 0.54]
  1 study · 152 participants
  Low

Buprenorphine maintenance vs buprenorphine detoxification

Buprenorphine maintenance showed no clear difference in use of primary substance Patients with positive urine test at the… compared with buprenorphine detoxification (low certainty).

• Maintenance treatments for opiate ‐dependent adolescents 2014 · Cochrane Headline outcomes only
  RR 0.97 [0.78, 1.22]
  1 study · 152 participants
  Low

Buprenorphine maintenance vs buprenorphine detoxification

Buprenorphine maintenance may leads to lower self reported use at 12‐month compared with buprenorphine detoxification (low certainty).

• Maintenance treatments for opiate ‐dependent adolescents 2014 · Cochrane Headline outcomes only
  RR 0.73 [0.57, 0.95]
  1 study · 152 participants
  Low

Buprenorphine maintenance vs buprenorphine detoxification

Buprenorphine maintenance showed no clear difference in enrolment in addiction treatment at 12‐month compared with buprenorphine detoxification (low certainty).

• Maintenance treatments for opiate ‐dependent adolescents 2014 · Cochrane Headline outcomes only
  RR 1.33 [0.94, 1.88]
  1 study · 152 participants
  Low

Community‐based buprenorphine vs placebo

It is very uncertain whether community‐based buprenorphine changes end of treatment drug use compared with placebo (very low certainty).

• Interventions for female drug‐using offenders 2019 · Cochrane Headline outcomes only
  RR 0.57 [0.27, 1.2]
  1 study · 36 participants
  Very low
• Interventions for female drug‐using offenders 2019 · Cochrane Headline outcomes only
  RR 0.58 [0.25, 1.35]
  1 study · 36 participants
  Very low