Buprenorphine vs methadone for opioid assisted withdrawal

Buprenorphine and methadone for opioid assisted withdrawal was found in a systematic review (Gowing et al., 2017, 27 RCTs, N = 3 048) to be equally effective in treatment outcomes and no difference between the two medications was detected in terms of:

• completion rates (RR 1.04, 95% CI 0.91 to 1.20, RCTs = 5; N = 457, moderate quality)
• average treatment duration (MD 1.30 days, 95% CI −8.11 to 10.72, RCTs = 2, N = 82, low quality)

Similarly, another systematic review (Baxley et al. 2022, 10 studies, N = 2468) also found that:

• buprenorphine effectively reduced cravings

In three studies, there was a greater craving for buprenorphine than methadone. Both methadone and buprenorphine were effective, but this systematic review does not provide enough evidence to determine whether one is more effective than the other.