Buprenorphine is more effective than clonidine at helping people withdraw from opioids

Buprenorphine is more effective than clonidine at helping people withdraw from opioids. It probably has similar effect as methadone, but withdrawal symptoms may resolve more quickly with buprenorphine.

These are the conclusions of a Cochrane Library systematic review that studied published research on the relative effectiveness of various treatments, including buprenorphine, clonidine, and methadone.

The Review is to be published in The Cochrane Library .

They found 18 studies, 14 of which were randomised controlled trials. The studies included a total of 1356 participants.

Comparing buprenorphine with clonidine: Patients treated with buprenorphine had less withdrawal symptoms, stayed in treatment for longer, and were more likely to complete treatments. There was no measurable difference in side-effects, although more people dropped out of clonidine treatment because of side-effects.

Comparing buprenorphine with methadone: There are less studies making this comparison, but the severity of withdrawal appears to be similar for the two treatments. Withdrawal symptoms tended to resolve more quickly with buprenorphine, and people may be more likely to complete withdrawal with buprenorphine treatment than with methadone.

"What we need to know now is the extent of rebound withdrawal after short periods of use of buprenorphine and methadone," says lead Review Author Dr Linda Gowing, who works in the World Health Organization Collaborating Centre for Research in the Treatment of Drug and Alcohol Problems at the University of Adelaide.