METHADONE VERSUS BUPRENORPHINE: TO STUDY THE EPIDEMIOLOGY AND COMPARE THE TREATMENT OUTCOME AS IN RETENTION RATE BETWEEN METHADONE AND BUPRENORPHINE TAKING OPIOID DEPENDENT PATIENTS FROM OST CENTER

RAJIV ARORA; SHINY DEHAL; NEERU BALA; KHUSHBINDER SINGH; HARSHPREET SINGH

doi:10.22159/ajpcr.2024v17i8.51106

Authors

RAJIV ARORA Department of Psychiatry, Government Medical College, Amritsar, Punjab, India
SHINY DEHAL Department of Psychiatry, Government Medical College, Amritsar, Punjab, India https://orcid.org/0009-0003-6522-0135
NEERU BALA Department of Psychiatry, Government Medical College, Amritsar, Punjab, India https://orcid.org/0000-0002-8526-953X
KHUSHBINDER SINGH Department of Psychiatry, Government Medical College, Amritsar, Punjab, India
HARSHPREET SINGH Department of General Medicine, Government Medical College and Hospital, Chandigarh, India. https://orcid.org/0000-0003-3816-7706

DOI:

https://doi.org/10.22159/ajpcr.2024v17i8.51106

Keywords:

Opioid substitution therapy, Opioid dependence, BPN, Methadone, Retention rate

Abstract

Objectives: The objective is to study sociodemographic profile and compare retention rate between methadone and buprenorphine (BPN) taking opioid-dependent patients from opioid substitution therapy (OST) centers.

Methods: Two hundred patients, 100 each on methadone and BPN already taking treatment from OST center under the Department of Psychiatry, GMC Amritsar and Civil Hospital, Kapurthala, were studied. The precise aim of the interview and the nature of the study were explained to the enrolled patients and patients were reassured about the confidentiality of the information given. In this 1-year study, patients were followed up at 3, 6 and 9 months and compared to find the drug associated with higher patient retention on treatment. Hence, establishing which drug is more effective in treatment adherence.

Results: The majority of patients, that is, about 80% in the BPN group and 93% in the methadone group were below 40 years of age. In the BPN group, 70% of subjects were married persons (70%) compared to 74% in the methadone group. Most patients in both groups were educated up to 10th and 12th standards. Most of the patients in both groups had duration of substance dependence between 5 and 10 years. In the BPN group, 51% of participants had previously attempted some treatment for drug abuse while in the methadone group, 57% had attempted the same.

Conclusion: After comparing the retention between the two drug groups, no statistically significant difference was found.

Downloads

Download data is not yet available.

References

Volkow ND. Principles of Drug Addiction Treatment: A Research- Based Guide. DIANE Publishing; 2011. Available from: https://www. drugabuse.gov

Degenhardt L, Larance B, Mathers B, Azim T, Kamarulzaman A, Mattick R, et al. Benefits and Risks of Pharmaceutical Opioids: Essential Treatment and Diverted Medication A Global Review of Availability, Extra-Medical Use, Injection and the Association with HIV; 2007. Available from: https://www.unodc.org/documents/hiv-aids/publications/Benefits_and_risks_of_pharmaceutical_opioids.pdf

National Programme for Tobacco Control and Drug Addiction Treatment. Standard Treatment Guidelines for the management of Substance Use Disorders and Behavioural Addictions. Ministry of Health and Family Welfare, Government of India; 2020. Available from: https://main.mohfw.gov.in/publications

Heroin Drug Facts: NIH: National Institute on Drug Abuse. Available from: https://www.drugabuse.gov/publications/drugfacts/heroin [Last accessed on 2020 Jul 24].

Anderson L. Heroin; 2014. Available from: http://www.drugs.com/ illicit/heroin.html

Kamble S, Poul B, Udapurkar P. Bilayer tablet of tramadol and gabapentine for combination pharmacotherapy of neuropathic pain: Development and characterization. Int J Appl Pharm. 2018;10(3):100-7.

Eddy NB, Halbach H, Isbell H, Seevers MH. Drug dependence: Its significance and characteristics. Bull World Health Organ. 1965;32(5):721-33. PMID 5294186

United Nations Office on Drugs and Crime; 2018. Available from: https://www.unodc.org

Borg L, Buonora M, Butelman ER, Ducat E, Ray BM, Kreek MJ. The Pharmacology of Opioids: The ASAM principles of Addiction Medicine. 5thed. US: Wolter Kluwer Health Adis (ESP); 2014. p. 50.

Srivastava A, Kahan M, Nader M. Primary care management of opioid use disorders: Abstinence, methadone, or BPN-naloxone? Can Fam Physician. 2017;63(3):200-5. PMID 28292795

Principles of Drug Addiction Treatment. A Research Base Guide. National Institute on Drug Abuse. National Institutes of Health U.S. Department of Health and Human Services. 3rded; July 2010. Available from: https://www.drugabuse.gov/sites/default/files/podat_1.pdf

Mundhey D, Sapkal N, Daud A. Fabrication of an abuse deterrent and micro emulsion based sublingual film of buprenorphine hydrochloride for breakthrough pain management. Int J Appl Pharm. 2020;12(6):127-35.

Punjab Opioid Dependence Survey (PODS); 2015. Available from: http://www.pbhealth.gov.in/scan0003%20(2).pdf

Hser YI, Saxon AJ, Huang D, Hasson A, Thomas C, Hillhouse M, et al. Treatment retention among patients randomized to BPN/ naloxone compared to methadone in a multi-site trial. Addiction. 2014;109(1):79-87. doi: 10.1111/add.12333, PMID 23961726

Giacomuzzi SM, Ertl M, Kemmler G, Riemer Y, Vigl A. Sublingual BPN and methadone maintenance treatment: A three-year follow-up of quality of life assessment. ScientificWorldJournal. 2005;5:21-9.

Basu D, Aggarwal M, Das PP, Mattoo SK, Kulhara P, Varma VK. Changing pattern of substance abuse in patients attending a de-addiction centre in north India (1978-2008). Indian J Med Res. 2012;135(6):830-6. PMID 22825602

Nigam AK, Ray R, Tripathi BM. BPN in opiate withdrawal: A comparison with clonidine. J Subst Abuse Treat. 1993;10(4):391-4. doi: 10.1016/0740-5472(93)90024-v, PMID 8257551

Lal B, Singh G. Alcohol consumption in Punjab. Indian J Psychiatry. 1978;20(3):212-6.

Avasthi A, Basu D, Subodh BN, Gupta PK, Sidhu BS, Gargi PD, et al. Epidemiology of substance use and dependence in the state of Punjab, India: Results of a household survey on a state wide representative sample. Asian J Psychiatry. 2018;33:18-29. doi: 10.1016/j. ajp.2018.02.017

Chavan BS, Arun P, Bhargava R, Singh GP. Prevalence of alcohol and drug dependence in rural and slum population of Chandigarh: A community survey. Indian J Psychiatry. 2007;49(1):44-8. doi: 10.4103/0019- 5545.31517, PMID 20640064

Malik P, Kumar N, Sidhu BS, Sharma KC, Gulia AD. Impact of substance dependence on primary caretaker in rural Punjab. Delhi Psychiatry J. 2012;15(1):72-8.

Rather YH, Bashir W, Sheikh AA, Amin M, Zahgeer YA. Socio-demographic and clinical profile of substance abusers attending a regional drug de-addiction centre in chronic conflict area: Kashmir, India. Malays J Med Sci. 2013;20(3):31-8. PMID 23966822

Mattoo SK, Nebhinani N, Kumar BA, Basu D, Kulhara P. Family burden with substance dependence: A study from India. Indian J Med Res. 2013;137(4):704-11. PMID 23703337

Singh A. Drug abuse among rural youth: A sociological study of Punjab. Int Refereed Res J. 2010;1(9):15-8.

Vivek K, Dalal P, Trivedi J, Pankaj K. A study of psychiatric comorbidity in opioid dependence. Delhi Psychiatry J. 2010;13(1):86-8.

Saluja BS, Grover S, Irpati AS, Mattoo SK, Basu D. Drug dependence in adolescents 1978–2003: A clinical-based observation from north India. Indian J Pediatr. 2007;74(5):455-8. doi: 10.1007/s12098-007- 0077-z, PMID 17526956

Margoob MA, Dutta KS. Drug abuse in Kashmir-experience from a psychiatric diseases hospital. Indian J Psychiatry. 1993;35(3):163-5. PMID 21743629

Farhat S, Hussain SS, Rather YH, Hussain SK. Sociodemographic profile and pattern of opioid abuse among patients presenting to a de-addiction centre in tertiary care hospital of Kashmir. J Basic Clin Pharm. 2015;6(3):94-7. doi: 10.4103/0976-0105.160751, PMID 26229346

Kalra I, Bansal PD. Sociodemographic profile and pattern of drug abuse among patients presenting to a de-addiction centre in rural area of Punjab. Psychiatry J. 2012;19:38-66.

Rapp RC, Xu J, Carr CA, Lane DT, Wang J, Carlson R. Treatment barriers identified by substance abusers assessed at a centralized intake unit. J Subst Abuse Treat. 2006;30(3):227-35. doi: 10.1016/j. jsat.2006.01.002, PMID 16616167

Kosten TR, Schottenfeld R, Ziedonis D, Falcioni J. BPN versus methadone maintenance for opioid dependence. J Nerv Ment Dis. 1993;18:358-64.

Soyka M, Zingg C, Koller G, Kuefner H. Retention rate and substance use in methadone and BPN maintenance therapy and predictors of outcome: Results from a randomized study. Int J Neuropsychopharmacol. 2008;11(5):641-53. doi: 10.1017/ S146114570700836X, PMID 18205978