Ali Shahid, Tahir Barira, Jabeen Shagufta, Malik Madeeha
Drs. Ali and Tahir are with the Smart Choice Treatment Center in Franklin, Tennessee. Ms. Malik is a Research Associate with the Smart Choice Treatment Center in Franklin, Tennessee. Dr. Jabeen is Site Director of the VA Residency Training Program in Nashville and Murfreesboro, Tennessee, and Site Director of the Geriatric Fellowship Program and Adjunct Associate Professor at Vanderbilt University, Nashville, Tennessee.
Innov Clin Neurosci. 2017 Aug 1;14(7-8):8-19. eCollection 2017 Jul-Aug.
Opiate misuse is a chronic relapsing disease that has become an epidemic in the United States. Methadone is the mainstay of treatment for opiate addiction and has been researched widely. Recently, new avenues of treatment have been researched and developed. The objective of this review is to study methadone in comparison to other pharmacological options available or being considered for opiate addiction treatment through a methodical search and review of evidence provided by recent clinical trials conducted in this regard. There is a paucity of high quality randomized controlled trials focusing on the comparison between buprenorphine and methadone for treatment of opiate use disorder. Buprenorphine should be researched more for patient retention and satisfaction, as well as for its prospect for better outcomes in neonatal abstinence syndrome to generate more decisive recommendations. Current data suggest monitoring of liver enzymes with the use of buprenorphine/naloxone for better liver outcomes. In light of the analyzed data, the authors conclude that methadone should still be considered the preferred treatment mode in comparison to slow-release oral morphine and heroin.
阿片类药物滥用是一种慢性复发性疾病，在美国已泛滥成灾。美沙酮是治疗阿片类药物成瘾的主要药物，并且已得到广泛研究。最近，人们研究并开发了新的治疗途径。本综述的目的是通过系统检索和回顾近期在这方面进行的临床试验所提供的证据，将美沙酮与其他现有的或正在考虑用于治疗阿片类药物成瘾的药理学选择进行比较研究。目前缺乏高质量的随机对照试验来聚焦丁丙诺啡与美沙酮在治疗阿片类药物使用障碍方面的比较。应进一步研究丁丙诺啡在患者留存率和满意度方面的情况，以及其在新生儿戒断综合征中取得更好疗效的前景，以便得出更具决定性的建议。目前的数据表明，使用丁丙诺啡/纳洛酮时监测肝酶有助于改善肝脏预后。根据分析的数据，作者得出结论，与缓释口服吗啡和海洛因相比，美沙酮仍应被视为首选的治疗方式。
