A randomised trial of effectiveness and cost effectiveness of supervised versus unsupervised administration of buprenorphine-naloxone for heroin dependence
NDARC Staff
Marian Shanahan
Other Investigators
James Bell and Anni Ryan (The Langton Centre); Adrian Dunlop (Turning Point); Adam Winstock (South Western Sydney Area Health Service); Robert Batey (Royal Newcastle Hospital)
Aims
Design and Method
This study was conducted at The Langton Centre, Royal Newcastle Hospital, and Bankstown Hospital in NSW, and at Turning Point in Victoria. This randomised control trial, recruited subjects on days 3-5 post inception to buprenorphine. Heroin users seeking maintenance treatment were randomly allocated to either supervised (daily administration) or unsupervised (weekly dispensed) medication for 3 months. All subjects received buprenorphine-naloxone, weekly clinical reviews, and research interviews at baseline and 3 months. The hypothesis of the study was that retention in treatment would be superior in unsupervised subjects. Primary end-points were retention in treatment, and heroin use at 3 months. Costs of treatment were measured, and cost-effectiveness of supervised and unsupervised treatment compared.
Progress
Benefits
Output
Shanahan, M. Estimating the cost-savings of reduced crime while on methadone treatment. Paper presented at the 2006 APSAD Conference, Cairns, Queensland, 6 November, 2006.
Bell, J. Cost-effectiveness comparison of two approaches to Opioid Maintenance Treatment. Paper presented at the 2007 Harm Reduction Conference, Warsaw, Poland, 15 May, 2007.
The following paper has been published:
Bell, J., Shanahan, M., Mutch, C., Rea, F., Ryan, A., Batey, R., Dunlop, A., & Winstock, A. (2007). A randomized trial of effectiveness and cost-effectiveness of observed versus unobserved administration of buprenorphine-naloxone for heroin dependence, Addiction 102, 1899-1907.
Funding
Reckittbenckiser and NSW Health