Advanced

Efficacy of maintenance treatment with methadone for opioid dependence: A meta-analytical study

Johansson, Björn Axel LU ; Berglund, Mats LU and Lindgren, Anna LU (2007) In Nordic Journal of Psychiatry 61(4). p.288-295
Abstract
The two aims of this study were to analyse the impact of methadone on outcome, and to confirm the results from previous meta-analyses by using a different methodology. The literature on randomized controlled trials ( RCT) of methadone as maintenance treatment for opioid dependence was systematically reviewed. Eight studies involving 1511 patients were included. Both dichotomous and continuous variables were transformed into the standardized effect size ( d). Homogeneity was analysed. A random effect model was used in all calculations. The combined analyses for retention, abuse and criminality were all significant: d = 0.90, d = 0.61, and d = 0.35, respectively. A test of heterogeneity was significant for all three outcomes: P<0.01 for... (More)
The two aims of this study were to analyse the impact of methadone on outcome, and to confirm the results from previous meta-analyses by using a different methodology. The literature on randomized controlled trials ( RCT) of methadone as maintenance treatment for opioid dependence was systematically reviewed. Eight studies involving 1511 patients were included. Both dichotomous and continuous variables were transformed into the standardized effect size ( d). Homogeneity was analysed. A random effect model was used in all calculations. The combined analyses for retention, abuse and criminality were all significant: d = 0.90, d = 0.61, and d = 0.35, respectively. A test of heterogeneity was significant for all three outcomes: P<0.01 for all comparisons. The type of study design was a significant moderator in five of nine comparisons: for retention in all three comparisons, concerning abuse in gradual detoxification vs. untreated controls and concerning criminality in placebo vs. untreated controls. In these subgroups, three of six studies were homogeneous. In one study, methadone maintenance treatment reduced abuse of illegal opioids in prisoners. We conclude that methadone maintenance treatment in opioid dependence shows positive effects on retention, opioid abuse and criminality compared with non-active controlled conditions. Type of study design could explain some of the heterogeneity found. A different meta-analytical approach made it possible to confirm effects of methadone on retention and opioid abuse from previous studies and document effect on criminality. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
opioid dependence, methadone, RCT, meta-analysis, maintenance treatment
in
Nordic Journal of Psychiatry
volume
61
issue
4
pages
288 - 295
publisher
Informa Healthcare
external identifiers
  • wos:000249182000007
  • scopus:34548379189
ISSN
1502-4725
DOI
10.1080/08039480701415251
language
English
LU publication?
yes
id
41c54e70-31e1-4ea5-aef5-eda621519cd0 (old id 657036)
date added to LUP
2007-12-13 11:46:58
date last changed
2017-01-01 04:25:22
@article{41c54e70-31e1-4ea5-aef5-eda621519cd0,
  abstract     = {The two aims of this study were to analyse the impact of methadone on outcome, and to confirm the results from previous meta-analyses by using a different methodology. The literature on randomized controlled trials ( RCT) of methadone as maintenance treatment for opioid dependence was systematically reviewed. Eight studies involving 1511 patients were included. Both dichotomous and continuous variables were transformed into the standardized effect size ( d). Homogeneity was analysed. A random effect model was used in all calculations. The combined analyses for retention, abuse and criminality were all significant: d = 0.90, d = 0.61, and d = 0.35, respectively. A test of heterogeneity was significant for all three outcomes: P&lt;0.01 for all comparisons. The type of study design was a significant moderator in five of nine comparisons: for retention in all three comparisons, concerning abuse in gradual detoxification vs. untreated controls and concerning criminality in placebo vs. untreated controls. In these subgroups, three of six studies were homogeneous. In one study, methadone maintenance treatment reduced abuse of illegal opioids in prisoners. We conclude that methadone maintenance treatment in opioid dependence shows positive effects on retention, opioid abuse and criminality compared with non-active controlled conditions. Type of study design could explain some of the heterogeneity found. A different meta-analytical approach made it possible to confirm effects of methadone on retention and opioid abuse from previous studies and document effect on criminality.},
  author       = {Johansson, Björn Axel and Berglund, Mats and Lindgren, Anna},
  issn         = {1502-4725},
  keyword      = {opioid dependence,methadone,RCT,meta-analysis,maintenance treatment},
  language     = {eng},
  number       = {4},
  pages        = {288--295},
  publisher    = {Informa Healthcare},
  series       = {Nordic Journal of Psychiatry},
  title        = {Efficacy of maintenance treatment with methadone for opioid dependence: A meta-analytical study},
  url          = {http://dx.doi.org/10.1080/08039480701415251},
  volume       = {61},
  year         = {2007},
}