Date of Award

5-2021

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Daryl Sieg

Second Advisor

Jeanie McHugo

Keywords

Buprenorphine; Methadone; Suboxone; Opioid use disorder; OUD; Opioids; Narcotics; UOverdose; Addiction; Opioid treatment

Abstract

The purpose of this literature review is to analyze the use of buprenorphine and methadone for the treatment of opioid use disorder. Comparison of overall safety, efficacy, morbidity and mortality between the two treatment options is accomplished throughout this literature review. The literature review was performed using databases: PubMed, Clinical Key, Cochrane and Upto- date. Results were limited to studies completed within the past seven years. Methadone has been the treatment mainstay of opioid use disorder for decades. buprenorphine has increased in popularity and prevalence for treatment of opioid use disorder, especially after receiving FDA approval for such use in 2002. Several benefits of buprenorphine therapy were discovered including a significant reduction in overdose fatalities, more convenient dosing options and easier access to prescribing locations. Treatment retention rates of those receiving buprenorphine was found to be lower, sometimes quite significantly, than those who received methadone therapy. A review of the literature showed that those receiving methadone for the treatment of opioid use disorder have a higher likelihood of hospitalization or fatal overdose during the initiation of therapy. A significantly higher retention rate was shown in those receiving methadone, in comparison to buprenorphine. However, methadone use was found to have an association with occurrences of neonatal abstinence syndrome in those taking the medication during pregnancy. A common negative theme throughout the literature review was the lack of a control population when comparing buprenorphine and methadone. Conclusively, neither methadone nor buprenorphine were found superior when used for treatment of opioid use disorder. Careful consideration must be given to the patient’s personal situation, drug use history and likelihood of compliance.

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