Addiction and Concurrent Disorders Group, Institute of Mental Health, Centre for Health Evaluation and Outcome Sciences, Department of Psychiatry, University of British Columbia, Vancouver, Canada.
Psychiatric Research Center, Roozbeh Hospital, Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran.
Int J Methods Psychiatr Res. 2019 Mar;28(1):e1768. doi: 10.1002/mpr.1768. Epub 2019 Feb 4.
This is the first study to compare the safety and efficacy of opium tincture (OT) with methadone for treatment of opioid use disorder.
In this multicenter, double-blind, noninferiority controlled trial, a stratified sample of 204 participants with opioid use disorder were recruited from community outreach, drop-in centers, and triangular clinics. Participants were excluded in case of active participation in another treatment program for opioid use disorder, hypersensitivity to trial medications, pregnancy, and certain serious medical conditions. They were randomized to receive either OT or methadone with an allocation ratio of 1:1 using a patient-centered flexible dosing strategy. Eligible participants were followed for a period of 12 weeks. Primary outcome is the difference in percentage of patients retained in the treatment. Secondary outcomes are craving, withdrawal symptoms, physical health, mental health, quality of life, and severity of substance use problems, cognitive function, safety profile, cost-effectiveness, and participants' satisfaction. Both intention-to-treat and per-protocol analyses will be conducted. The Ethics Board of the University of British Columbia and Tehran University of Medical Sciences approved the study. (clinicaltrials.gov; NCT02502175).
To be reported after final analysis.
If shown to be effective, OT will diversify the options for medication-assisted treatment of opioid use disorder.
这是第一项比较鸦片酊(OT)与美沙酮治疗阿片类药物使用障碍的安全性和疗效的研究。
在这项多中心、双盲、非劣效性对照试验中,从社区外展、中途停留中心和三角诊所招募了 204 名阿片类药物使用障碍的分层样本参与者。排除正在积极参与另一种阿片类药物使用障碍治疗方案、对试验药物过敏、怀孕和某些严重疾病的参与者。他们按照 1:1 的比例随机分配接受 OT 或美沙酮治疗,采用以患者为中心的灵活剂量策略。符合条件的参与者接受为期 12 周的随访。主要结局是治疗中保留的患者百分比差异。次要结局是渴望、戒断症状、身体健康、心理健康、生活质量和物质使用问题的严重程度、认知功能、安全性、成本效益以及参与者的满意度。将进行意向治疗和方案分析。不列颠哥伦比亚大学和德黑兰医科大学伦理委员会批准了这项研究。(clinicaltrials.gov;NCT02502175)。
将在最终分析后报告。
如果证明有效,OT 将使阿片类药物使用障碍的药物辅助治疗选择多样化。