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Study investigating which drug is most effective for getting off prescription opioids

Researchers are looking for about 35 people addicted to prescription opioids for a study comparing the effectiveness of methadone and Suboxone

A bottle of methadone, the traditional treatment for opioid addiction. A group of researchers is studying to see if Suboxone, a newer drug, is just as effective in treating prescription opioid addiction.

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A bottle of methadone, the traditional treatment for opioid addiction. A group of researchers is studying to see if Suboxone, a newer drug, is just as effective in treating prescription opioid addiction.

A new research study is seeking to determine what the most effective drug for getting people off prescription opioids is: methadone or Suboxone.

And researchers are looking for about 35 people in Edmonton who are addicted to prescription opioids to take part in a clinical trial.

Since the 1950s, methadone, an opioid usually taken orally, has been used as the main drug of choice for treating people who are dependant on opioids.

But earlier this month, the Canadian Research Initiative in Substance Misuse recommended Suboxone, a combination of semi-synthetic opioid buprenorphine and life-saving drug naloxone, as the first choice for treatment. Suboxone was approved for medical use in Canada in 2007.

The differences are significant: methadone can be combined with other opioids to get high, and is easier to overdose on, whereas Suboxone blocks the effect of other opioids, such as heroin or fentanyl.

Many experts say Suboxone is less prone to abuse, because it's harder to overdose on. Furthermore, it's easier for physicans to prescribe, whereas methadone requires a special licence.

“Until recently … Most provinces saw methadone as the first line treatment and Suboxone as something to try only after methadone failed,” said Cam Wild, principal investigator for the Canadian Research Initiative in Substance Use Prairie Node, the organization undertaking the study.

But researchers are now recommending Suboxone as the first treatment option because of the advantages it provides over methadone.

Methadone patients have to adhere to a rigid schedule of checking in and being monitored by their doctor, because it has higher addiction and overdose potential.

“The access for the public to get methadone treatment is restricted,” said Ron Lim, clinical lead for the study and medical lead of the Calgary Opioid Dependency Program.  

“Suboxone is so much more easier to use, it’s safer and it can be used and prescribed in a family physician office … We’re trying to prove that with Suboxone, we can as effectively treat prescription opioid abuse,” Lim added.

According to Lim, the project is one of the first studies to specifically focus on how to treat people addicted to prescription opioids.

“There have been lots of studies around since the 1970s that research heroin users ... There haven’t been a lot of actual studies on prescription opioids,” Lim said.

It’s also the first study of its kind to focus specifically on Canadian patients.

Lim said part of the reason the study focuses on people trying to quit prescription opioids is because of the explosive rise in deaths from prescription opioid overdoses, including fentanyl.

“For the longest time, heroin was the most potent available opioid you could get … more recently, people are moving towards fentanyl,” Lim said.

Fentanyl is also becoming more popular on the street when compared to heroin, due to price and availability, Lim said.

“On the west coast ... the heroin supply has almost completely dried up due to the cost,” Lim said. “It’s now cheaper to buy prescription opioids on the street compared to heroin.”

The study and clinical trial are currently in the recruitment phase for the next 18 months. Once it starts, the study expected to last 28 weeks. Patients will randomly be assigned either methadone or Suboxone and will complete questionnaires based on their experience.

Emergency measures by the province, such as introducing naloxone take-home kits and opening supervised consumption drugs, are about keeping people alive long enough to seek treatment. This is the next step in addressing the opioid crisis, Lim said.

“It’s a much more long-term solution … this is a way to actually get the individual who is addicted to opioids out of their active addiction.”

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