Giacomuzzi Salvatore M, Ertl Markus, Kemmler Georg, Riemer Yyvonne, Vigl Alexander
University Department of Psychiatry, Anichstrasse 35, 6020 Innsbruck, Austria.
ScientificWorldJournal. 2005 May 24;5:452-68. doi: 10.1100/tsw.2005.52.
This study was conducted to compare long-term outcome effects on the quality of life (QOL) of oral methadone with sublingual buprenorphine maintenance treatment. The QOL status of opioid-dependent patients was assessed using the German version ("Berlin Quality of Life Profile") of the Lancashire Quality of Life Profile. Physical symptoms were measured using the Opiate Withdrawal Scale (OWS). Urine tests were carried out randomly to detect additional consumption. In the first study period, 53 opioid-dependent subjects were enrolled and 25 could be reached after 3 years. The retention rate was 50% for methadone and 45% for buprenorphine (p = 0.786). Baseline values of the total sample (completers and noncompleters) QOL and somatic complaints did not show significant differences between the two treatment groups. QOL characteristics at 6 months of treatment of the buprenorphine completer and noncompleter groups differed significantly regarding job (p = 0.013), family, and total score of physical symptoms (p = 0.002), in which the completer group showed the more favorable values. Concerning physical symptoms at 36 months, logistic regression revealed significantly less stomach cramps (p = 0.037) and fatigue and tiredness (p = 0.034) in buprenorphine compared to the methadone. Moreover, the buprenorphine-maintained group showed significantly less additional consumption of benzodiazepines (p = 0.015) compared with methadone participants. It is concluded that opioid addicts improved their QOL and health status when treated with methadone or buprenorphine. In summary, regarding QOL and health status, the present data indicate that buprenorphine is also a useful long-term alternative for maintenance treatment of opioid-dependent patients.
本研究旨在比较口服美沙酮与舌下含服丁丙诺啡维持治疗对生活质量(QOL)的长期影响。使用《兰开夏郡生活质量量表》的德文版(“柏林生活质量概况”)评估阿片类药物依赖患者的生活质量状况。使用阿片戒断量表(OWS)测量身体症状。随机进行尿液检测以检测额外的药物使用情况。在第一个研究阶段,招募了53名阿片类药物依赖受试者,3年后联系到了其中25人。美沙酮组的保留率为50%,丁丙诺啡组为45%(p = 0.786)。两个治疗组的总样本(完成者和未完成者)生活质量和躯体不适的基线值没有显著差异。丁丙诺啡完成者组和未完成者组在治疗6个月时的生活质量特征在工作方面(p = 0.013)、家庭方面以及身体症状总分方面(p = 0.002)存在显著差异,其中完成者组的值更有利。关于36个月时的身体症状,逻辑回归显示,与美沙酮相比,丁丙诺啡组的胃痉挛(p = 0.037)以及疲劳和疲倦(p = 0.034)显著更少。此外,与美沙酮参与者相比,丁丙诺啡维持治疗组的苯二氮䓬类药物额外使用量显著更少(p = 0.015)。得出的结论是,阿片类药物成瘾者在接受美沙酮或丁丙诺啡治疗时,其生活质量和健康状况得到改善。总之,就生活质量和健康状况而言,目前的数据表明,丁丙诺啡也是阿片类药物依赖患者维持治疗的一种有用的长期替代药物。