Cochrane · systematic review · CD011117
Opioid agonist treatment for people who are dependent on pharmaceutical opioids
Nielsen, S, Tse, WC, Larance, B · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
10
current version
GRADE rated
10
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 2 · 20%Low 6 · 60%Moderate 2 · 20%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyFull opioid agonists versus different full opioid agonists or partial opioid agonists (methadone versus buprenorphine) for maintenance
Population: people dependent on pharmaceutical opioids
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Illicit opioid use Full opioid agonists vs different full opioid agonists or partial opioid agonists (methadone versus buprenorphine) | no estimate extracted | 1 study · 129 participants | Moderate Downgraded: risk of bias, imprecision |
Illicit opioid use Full opioid agonists vs different full opioid agonists or partial opioid agonists (methadone versus buprenorphine) | RR 0.81 [0.57, 1.17] | 3 studies · 206 participants | Low Downgraded: risk of bias, imprecision |
Illicit opioid use Full opioid agonists vs different full opioid agonists or partial opioid agonists (methadone versus buprenorphine) | RR 0.49 [0.28, 0.86] | 3 studies · 165 participants | Low Downgraded: risk of bias, imprecision |
Retention Full opioid agonists vs different full opioid agonists or partial opioid agonists (methadone versus buprenorphine) | RR 1.21 [1.02, 1.43] | 4 studies · 379 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Adverse effects Full opioid agonists vs different full opioid agonists or partial opioid agonists (methadone versus buprenorphine) | RR 0.45 [0.09, 2.41] | 3 studies · 206 participants | Low Downgraded: risk of bias, imprecision |
Full or partial opioid agonist maintenance versus placebo, detoxification only or psychological treatment (buprenorphine maintenance compared to taper or treatment as usual)
Population: pharmaceutical opioid dependent people
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Days of unsanctioned opioid use (as number of days/30 or days/7) Full or partial opioid agonist maintenance vs placebo, detoxification only or psychological treatment (buprenorphine maintenance compared to taper or treatment | SMD 0.19 | 3 studies · 205 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Self‐reported opioid use at treatment completion Full or partial opioid agonist maintenance vs placebo, detoxification only or psychological treatment (buprenorphine maintenance compared to taper or treatment | RR 0.63 [0.39, 1.01] | 4 studies · 276 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Opioid use Full or partial opioid agonist maintenance vs placebo, detoxification only or psychological treatment (buprenorphine maintenance compared to taper or treatment | RR 0.66 [0.52, 0.84] | 4 studies · 270 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Retention: proportion of participants retained in treatment Full or partial opioid agonist maintenance vs placebo, detoxification only or psychological treatment (buprenorphine maintenance compared to taper or treatment | RR 3.02 [1.73, 5.27] | 4 studies · 333 participants | Moderate Downgraded: inconsistency |
Adverse events Full or partial opioid agonist maintenance vs placebo, detoxification only or psychological treatment (buprenorphine maintenance compared to taper or treatment | RR 0.5 [0.07, 3.48] | 3 studies · 252 participants | Very low Downgraded: risk of bias, inconsistency |
Full opioid agonists versus different full opioid agonists or partial opioid agonists (methadone versus buprenorphine) for maintenance
Population: pharmaceutical opioid dependent people
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Opioid use Full opioid agonists vs different full opioid agonists or partial opioid agonists (methadone versus buprenorphine) | no estimate extracted | 1 study · 129 participants | Moderate Downgraded: risk of bias, imprecision |
Opioid use Full opioid agonists vs different full opioid agonists or partial opioid agonists (methadone versus buprenorphine) | RR 0.81 [0.56, 1.18] | 2 studies · 196 participants | Moderate Downgraded: risk of bias, imprecision |
Opioid use Full opioid agonists vs different full opioid agonists or partial opioid agonists (methadone versus buprenorphine) | RR 0.37 [0.08, 1.63] | 2 studies · 155 participants | Moderate Downgraded: risk of bias, imprecision |
Retention Full opioid agonists vs different full opioid agonists or partial opioid agonists (methadone versus buprenorphine) | RR 0.69 [0.39, 1.22] | 3 studies · 360 participants | Low Downgraded: risk of bias, imprecision |
Full or partial opioid agonist maintenance versus placebo, detoxification only or psychological treatment (buprenorphine maintenance compared to taper or treatment as usual)
Population: pharmaceutical opioid dependent people
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Days of unsanctioned opioid use Full or partial opioid agonist maintenance vs placebo, detoxification only or psychological treatment (buprenorphine maintenance compared to taper or treatment | no estimate extracted | 2 studies · 133 participants | Low |
Self reported opioid use at treatment completion Full or partial opioid agonist maintenance vs placebo, detoxification only or psychological treatment (buprenorphine maintenance compared to taper or treatment | RR 0.54 [0.31, 0.93] | 3 studies · 204 participants | Low |
Opioid use Full or partial opioid agonist maintenance vs placebo, detoxification only or psychological treatment (buprenorphine maintenance compared to taper or treatment | RR 0.63 [0.43, 0.91] | 3 studies · 206 participants | Low |
Retention Full or partial opioid agonist maintenance vs placebo, detoxification only or psychological treatment (buprenorphine maintenance compared to taper or treatment | RR 0.33 [0.23, 0.47] | 3 studies · 247 participants | Moderate |