***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Abstract Background Buprenorphine dependence is a relatively novel addiction . Aims To compare the treatment outcome in three groups over 12-weeks of treatment . Methods Two hundred and four intravenous (IV)-buprenorphine-dependent patients were r and omised into three groups . Subjects received 50 mg oral methadone tablet , or 5 mg sublingual buprenorphine tablet , or 50 mg oral naltrexone , and a weekly 30-minute clinical counselling session . Results The majority ( 80 % ) had a history of opium or heroin dependency before they were introduced to IV buprenorphine . The main source of buprenorphine for misusers was street sale ( 91 % ) . The mean duration of buprenorphine dependence was 1.9 years and the mean dose per day was 3.9 ampoules ( 1 ampoule contains 0.3 mg of buprenorphine in 1ml ) . Overall 59 % of the patients completed the 12-week study . Retention in the 50 mg methadone group was significantly better than the 5 mg dose buprenorphine group ( p=0.001 ) and the 50 mg dose naltrexone group ( p=0.000 ) . Retention in the 5 mg buprenorphine group was significantly better than the 50 mg naltrexone dose group ( p=0.000 ) . Conclusions These results support the efficacy and safety of oral methadone and sublingual buprenorphine tablets for injection buprenorphine-dependent patients BACKGROUND The partial opiate-receptor agonist buprenorphine has been suggested for treatment of heroin dependence , but there are few long-term and placebo-controlled studies of its effectiveness . We aim ed to assess the 1-year efficacy of buprenorphine in combination with intensive psychosocial therapy for treatment of heroin dependence . METHODS 40 individuals aged older than 20 years , who met DSM-IV criteria for opiate dependence for at least 1 year , but did not fulfil Swedish legal criteria for methadone maintenance treatment were r and omly allocated either to daily buprenorphine ( fixed dose 16 mg sublingually for 12 months ; supervised daily administration for a least 6 months , possible take-home doses thereafter ) or a tapered 6 day regimen of buprenorphine , thereafter followed by placebo . All patients participated in cognitive-behavioural group therapy to prevent relapse , received weekly individual counselling sessions , and su bmi tted thrice weekly supervised urine sample s for analysis to detect illicit drug use . Our primary endpoint was 1-year retention in treatment and analysis was by intention to treat . FINDINGS 1-year retention in treatment was 75 % and 0 % in the buprenorphine and placebo groups , respectively ( p=0.0001 ; risk ratio 58.7 [ 95 % CI 7.4 - 467.4 ] ) . Urine screens were about 75 % negative for illicit opiates , central stimulants , cannabinoids , and benzodiazepines in the patients remaining in treatment . INTERPRETATION The combination of buprenorphine and intensive psychosocial treatment is safe and highly efficacious , and should be added to the treatment options available for individuals who are dependent on heroin Most research examining buprenorphine has been conducted with heroin users . Few studies have examined buprenorphine pharmacotherapy for prescription opioid users . Data were from a r and omized controlled trial of behavioral treatment provided for 16weeks on a platform of buprenorphine pharmacotherapy and medication management . We compared  heroin ( H , n=54 ) , prescription opioid ( PO , n=54 ) and combination heroin+prescription opioid ( POH , n=71 ) users to test the hypothesis that PO users will have better treatment outcomes compared with heroin users . The PO group provided more opioid-negative urine drug screens over the combined treatment period ( PO:70 % , POH:40 % , H:38 % , p<0.001 ) and at the end of the combined treatment period ( PO:65 % , POH:31 % , H:33 % , p<0.001 ) . Retention was lowest in the H group ( PO:80 % , POH:65 % , H:57 % , p=0.039 ) . There was no significant difference in buprenorphine dose between the groups . PO users appear to have better outcomes in buprenorphine pharmacotherapy  compared to those reporting any heroin use , confirming that buprenorphine pharmacotherapy is effective in PO users AIMS To evaluate the safety and efficacy of buprenorphine implants ( BI ) versus placebo implants ( PI ) for the treatment of opioid dependence . A secondary aim compared BI to open-label sublingual buprenorphine/naloxone tablets ( BNX ) . DESIGN R and omized , double-blind , placebo-controlled trial . Subjects received either four buprenorphine implants ( 80 mg/implant ) ( n = 114 ) , four placebo implants ( n = 54 ) or open-label BNX ( 12 - 16 mg/day ) ( n = 119 ) . SETTING Twenty addiction treatment centers . PARTICIPANTS Adult out- patients ( ages 18 - 65 ) with DSM-IV-TR opioid dependence . MEASUREMENTS The primary efficacy end-point was the percentage of urine sample s negative for opioids collected from weeks 1 to 24 , examined as a cumulative distribution function ( CDF ) . FINDINGS The BI CDF was significantly different from placebo ( P < 0.0001 ) . Mean [ 95 % confidence interval ( CI ) ] proportions of urines negative for opioids were : BI = 31.2 % ( 25.3 , 37.1 ) and PI = 13.4 % ( 8.3 , 18.6 ) . BI subjects had a higher study completion rate relative to placebo ( 64 versus 26 % , P < 0.0001 ) , lower clinician-rated ( P < 0.0001 ) and patient-rated ( P < 0.0001 ) withdrawal , lower patient-ratings of craving ( P < 0.0001 ) and better subjects ' ( P = 0.031 ) and clinicians ' ( P = 0.022 ) global ratings of improvement . BI also result ed in significantly lower cocaine use ( P = 0.0016 ) . Minor implant-site reactions were comparable in the buprenorphine [ 27.2 % ( 31 of 114 ) ] and placebo groups [ 25.9 % ( 14 of 54 ) ] . BI were non-inferior to BNX on percentage of urines negative for opioids [ mean ( 95 % CI ) = 33.5 ( 27.3 , 39.6 ) ; 95 % CI for the difference of proportions = ( -10.7 , 6.2 ) ] . CONCLUSIONS Compared with placebo , buprenorphine implants result in significantly less frequent opioid use and are non-inferior to sublingual buprenorphine/naloxone tablets CONTEXT No r and omized trials have examined treatments for prescription opioid dependence , despite its increasing prevalence . OBJECTIVE To evaluate the efficacy of brief and extended buprenorphine hydrochloride-naloxone hydrochloride treatment , with different counseling intensities , for patients dependent on prescription opioids . DESIGN Multisite , r and omized clinical trial using a 2-phase adaptive treatment research design . Brief treatment ( phase 1 ) included 2-week buprenorphine-naloxone stabilization , 2-week taper , and 8-week postmedication follow-up .  Patients with successful opioid use outcomes exited the study ; unsuccessful patients entered phase 2 : extended ( 12-week ) buprenorphine-naloxone treatment , 4-week taper , and 8-week postmedication follow-up . SETTING Ten US sites . Patients A total of 653 treatment-seeking out patients dependent on prescription opioids . INTERVENTIONS In both phases , patients were r and omized to st and ard medical management ( SMM ) or SMM plus opioid dependence counseling ; all received buprenorphine-naloxone . MAIN OUTCOME MEASURES Predefined " successful outcome " in each phase : composite measures indicating minimal or no opioid use based on urine test-confirmed self-reports . RESULTS During phase 1 , only 6.6 % ( 43 of 653 ) of patients had successful outcomes , with no difference between SMM and SMM plus opioid dependence counseling . In contrast , 49.2 % ( 177 of 360 ) attained successful outcomes in phase 2 during extended buprenorphine-naloxone treatment ( week 12 ) , with no difference between counseling conditions . Success rates 8 weeks after completing the buprenorphine-naloxone taper ( phase 2 , week 24 ) dropped to 8.6 % ( 31 of 360 ) , again with no counseling difference . In secondary analyses , successful phase 2 outcomes were more common while taking buprenorphine-naloxone than 8 weeks after taper ( 49.2 % [ 177 of 360 ] vs 8.6 % [ 31 of 360 ] , P < .001 ) . Chronic pain did not affect opioid use outcomes ; a history of ever using heroin was associated with lower phase 2 success rates while taking buprenorphine-naloxone . CONCLUSIONS Prescription opioid-dependent patients are most likely to reduce opioid use during buprenorphine-naloxone treatment ; if tapered off buprenorphine-naloxone , even after 12 weeks of treatment , the likelihood of an unsuccessful outcome is high , even in patients receiving counseling in addition to SMM CONTEXT Limitations of existing pharmacological treatments for opioid dependence include low adherence , medication diversion , and emergence of withdrawal symptoms . OBJECTIVE To determine the efficacy of buprenorphine implants that provide a low , steady level of buprenorphine over 6 months for the treatment of opioid dependence . DESIGN , SETTING , AND PARTICIPANTS A r and omized , placebo-controlled , 6-month trial conducted at 18 sites in the United States between April 2007 and June 2008 . One hundred sixty-three adults , aged 18 to 65 years , diagnosed with opioid dependence . One hundred eight were r and omized to receive buprenorphine implants and 55 to receive  placebo implants . INTERVENTION After induction with sublingual buprenorphine-naloxone tablets , patients received either 4 buprenorphine implants ( 80 mg per implant ) or 4 placebo implants . A fifth implant was available if a threshold for rescue use of sublingual buprenorphine-naloxone treatment was exceeded . St and ardized individual drug counseling was provided to all patients . MAIN OUTCOME MEASURE The percentage of urine sample s negative for illicit opioids for weeks 1 through 16 and for weeks 17 through 24 . RESULTS The buprenorphine implant group had significantly more urine sample s negative for illicit opioids during weeks 1 through 16 ( P = .04 ) . Patients with buprenorphine implants  had a mean percentage of urine sample s that tested negative for illicit opioids across weeks 1 through 16 of 40.4 % ( 95 % confidence interval [ CI ] , 34.2%-46.7 % ) and a median of 40.7 % ; whereas those in the placebo group had a mean of 28.3 % ( 95 % CI , 20.3%-36.3 % ) and a median of 20.8 % . A total of 71 of 108 patients ( 65.7 % ) who received buprenorphine implants completed the study vs 17 of 55 ( 30.9 % ) who received placebo implants ( P < .001 ) . Those who received buprenorphine implants also had fewer clinician-rated ( P < .001 ) and patient-rated ( P = .004 ) withdrawal symptoms , had lower patient ratings of craving ( P < .001 ) , and experienced a greater change on clinician global ratings of severity of opioid dependence ( P<.001 ) and on the clinician global ratings of improvement ( P < .001 ) than those who received placebo implants . Minor implant site reactions were the most common adverse events : 61 patients ( 56.5 % ) in the buprenorphine group and 29 ( 52.7 % ) in the placebo group . CONCLUSION Among persons with opioid dependence , the use of buprenorphine implants compared with placebo result ed in less opioid use over 16 weeks as assessed by urine sample s. TRIAL REGISTRATION clinical trials.gov Identifier : NCT00447564 CONTEXT The usual treatment for opioid-addicted youth is detoxification and counseling . Extended medication-assisted therapy may be more helpful . OBJECTIVE To evaluate the efficacy of continuing buprenorphine-naloxone for 12 weeks vs detoxification for opioid-addicted youth . DESIGN , SETTING , AND PATIENTS Clinical trial at 6 community programs from July 2003 to December 2006 including 152 patients aged 15 to 21 years who were r and omized to 12 weeks of bupr 
    Output:
    
There was moderate quality evidence favouring  buprenorphine maintenance over detoxification or psychological treatment on adverse events ( RR 0.19 , 95 % CI 0.06 to 0.57).The main weaknesses in the quality of the data was the use of open-label study design s. AUTHORS ' CONCLUSIONS There was low to moderate quality evidence supporting the use of maintenance agonist pharmacotherapy for pharmaceutical opioid dependence .
Methadone or buprenorphine appeared equally effective .
Maintenance treatment with buprenorphine appeared more effective than detoxification or psychological treatments .