***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: This study a ) compared the effects of buprenorphine versus methadone maintenance on benzodiazepine and alcohol use and b ) evaluated the prognostic significance of gender and psychopathology and their interaction with maintenance treatment . Eighty male and 36 female patients were r and omly assigned to daily sublingual buprenorphine ( 4 or 12 mg ) or oral methadone ( 20 or 65 mg ) . Maintenance medication was not associated with significant differences in alcohol or benzodiazepine use . Rates of abstinence from illicit opioids were significantly higher for females , within the buprenorphine 4-mg group , females also had significantly better retention , lower rates of opioid-positive urine sample s , and higher rates of abstinence from illicit opioids . Lifetime sedative dependence was associated with significantly better retention , decreased rates of cocaine-positive urine sample s , and increased rates of cocaine abstinence ; among buprenorphine- but not methadone-maintained patients , it was also associated with increased rates of abstinence from illicit opioids The efficacy of buprenorphine and methadone was compared in the outpatient detoxification of heroin addicts . Forty‐five patients were r and omized to receive either sublingual buprenorphine or oral methadone under double‐dummy and double‐blind conditions to study the pharmacology of buprenorphine in a 90‐day detoxification protocol . The patients were administered either 2 mg buprenorphine or 30 mg methadone for 3 weeks followed by 4 weeks of dose reductions and 6 weeks of placebo medication . No significant between‐group differences were seen on measures of treatment retention , drug use , or symptom report . During the hydromorphone challenge , methadone  attenuated opioid effects to a greater extent than did buprenorphine on both physiologic ( pupil constriction ) and self‐report measures . However , this did not result in greater abuse of illicit opioid drugs by subjects taking buprenorphine . The results of this clinical trial indicated that buprenorphine was acceptable to patients and as effective as methadone in the detoxification treatment of heroin addicts Buprenorphine , a mu-opioid partial agonist , has demonstrated efficacy for the treatment of opioid dependence comparable to that of methadone . The clinical utility of buprenorphine would be enhanced if it could be dosed on a less than daily basis . The current study is a parallel-group outpatient clinical trial of daily versus alternate-day dosing with 8 mg sublingual ( s.l . ) buprenorphine .  Participants were r and omly assigned to daily ( n = 51 ) or alternate-day ( n = 48 ) schedules of active medication administration for an 11-week double-blind trial . Patients assigned to alternate-day buprenorphine received placebo every other day . Primary outcome measures were retention in treatment and urine specimens positive for opiates . Clinic attendance , dose adequacy ratings , withdrawal symptomatology , and urine specimens positive for cocaine were secondary outcome measures . Neither endpoint analysis with the intent-to-treat sample nor time course analysis with treatment completers revealed any statistically significant differences between the dosing schedules on any outcome measure . Examination of 95 % confidence intervals suggested a non-significant trend for the daily dosing schedule to have superior clinical efficacy at the dose tested . Nevertheless , these results are generally consistent with previous studies of less than daily dosing with buprenorphine and support the conclusion that an alternate-day dosing schedule can be effective in and acceptable to a substantial portion of patients AIMS To evaluate the effectiveness of buprenorphine compared with methadone maintenance therapy in opiate addicts over a treatment period of 24 weeks . DESIGN Subjects were r and omized to receive either buprenorphine or methadone in an open , comparative study . SETTING Subjects were recruited and treated at the drug addiction outpatient clinic at the University of Vienna . PARTICIPANTS Sixty subjects ( 19 females and 41 males ) who met DSM-IV criteria for opioid dependence and were seeking treatment . INTERVENTION Subjects received either sublingual buprenorphine ( 2-mg or 8-mg tablets ; maximum daily dose 8 mg ) or oral methadone ( racemic D -/+ L-methadone ; maximum daily dose 80 mg ) . A stable dose was maintained following the 6-day induction phase . MEASUREMENT Assessment of treatment retention and illicit substance use ( opiates , cocaine and benzodiazepines ) was made by urinalysis . FINDINGS The retention rate was significantly better in the methadone maintained group ( p < 0.05 ) but subjects completing the study in the buprenorphine group had significantly lower rates of illicit opiate consumption ( p = 0.04 ) . CONCLUSION The results support the superiority of methadone with respect to retention rate . However , they also confirm previous reports of buprenorphine use as an alternative in maintenance therapy for opiate addiction , suggesting that a specific subgroup may be benefiting from buprenorphine . This is the first comparative trial to use sublingual buprenorphine tablets : previously published comparison studies refer to 30 % solutions of buprenorphine in alcohol AIMS To evaluate the safety and efficacy of an 8 mg/day sublingual dose of buprenorphine in the maintenance treatment of heroin addicts by comparison with a 1 mg/day dose over a 16-week treatment period . As a secondary objective , outcomes were determined concurrently for patients treated with two other dose levels . DESIGN Patients were r and omized to four dosage groups and treated double-blind . SETTING Twelve outpatient opiate maintenance treatment centers throughout the United States . PARTICIPANTS Two hundred and thirty-nine women and 497 men who met the DSM-III-R criteria for opioid dependence and were seeking treatment . INTERVENTION Patients received either 1 , 4 , 8 or 16 mg/day of buprenorphine and were treated in the usual clinical context , including a 1-hour weekly clinical counseling session . MEASUREMENT Retention in treatment , illicit opioid use as determined by urine toxicology , opioid craving and global ratings by patient and staff . Safety outcome measures were provided by clinical monitoring and by analysis of the reported adverse events . FINDINGS Outcomes in the 8 mg group were significantly better than in the 1 mg group in all four efficacy domains . No deaths occurred in either group . The 8 mg group did not show an increase in the frequency of adverse events . Most reported adverse effects were those commonly seen in patients treated with opioids . CONCLUSIONS The findings support the safety and efficacy of buprenorphine and suggest that an adequate dose of buprenorphine will be a useful addition to pharmacotherapy Buprenorphine at 2 mg and 6 mg daily was compared with methadone at 35 mg and 65 mg during 24 weeks of maintenance among 125 opioid-dependent patients . As hypothesized , 6 mg of buprenorphine were superior to 2 mg of buprenorphine in reducing illicit opioid use , but higher dosage did not improve treatment retention . Self-reported illicit opioid use declined substantially in all groups , but by the third month , significantly more heroin abuse was reported at 2 mg than at 6 mg of buprenorphine or of methadone . From an initial average of $ 1860/month , month 3 usage dropped to $ 41 ( methadone 65 mg ) , $ 73 ( methadone 35 mg ) , $ 118 ( buprenorphine 6 mg ) , and $ 35I/month ( buprenorphine 2 mg ) . Days of use also dropped from 29 days to 1.7 ( methadone 65 mg ) , 2.8 ( methadone 35 mg ) , 4.0 ( buprenorphine 6 mg ) , and 6.6 days/month ( buprenorphine 2 mg ) . This relatively low efficacy for 2 mg of buprenorphine persisted through month 6 of the trial , with 7.2 days/month and $ 235/month of use for buprenorphine at 2 mg versus 1.9 days/month and $ 65/month for the other three groups . Increased opioid abuse also was associated with significantly greater and persistent opioid withdrawal symptoms . Our secondary hypothesis , that buprenorphine would be equivalent to methadone in efficacy , was not supported . Treatment retention was significantly better on methadone ( 20 us . 16 weeks ) , and methadone patients had significantly more opioid-free urines ( 51 % vs. 26 % ) . Abstinence for at least 3 weeks was also more common on methadone than buprenorphine ( 65 % vs. 27 % ) . Thus , methadone was clearly superior to these two buprenorphine doses , but illicit opioid use was reduced more by higher than lower buprenorphine dosage . Future studies need to examine higher sublingual buprenorphine doses of 12 mg to 20 mg daily for potential efficacy AIMS To assess the efficacy of buprenorphine compared with methadone maintenance therapy for opioid dependence in a large sample using a flexible dosing regime and the marketed buprenorphine tablet . DESIGN Patients were r and omized to receive buprenorphine or methadone over a 13-week treatment period in a double-blind , double-dummy trial . SETTING Three methadone clinics in Australia . PARTICIPANTS Four hundred and five opioid-dependent patients seeking treatment . INTERVENTION Patients received buprenorphine or methadone as indicated clinical ly using a flexible dosage regime . During weeks 1 - 6 , patients were dosed daily . From weeks 7 - 13 , buprenorphine patients received double their week 6 dose on alternate days . MEASUREMENTS Retention in treatment , and illicit opioid use as determined by urinalysis . Self-reported drug use , psychological functioning , HIV-risk behaviour , general health and subjective ratings were secondary outcomes . FINDINGS Intention-to-treat analyses revealed no significant difference in completion rates at 13 weeks . Methadone was superior to buprenorphine in time to termination over the 13-week period ( Wald chi 2 = 4.371 , df = 1 , P = 0.037 ) , but not separately for the single-day or alternate-day dosing phases . There were no significant between-group differences in morphine-positive urines , or in self-reported heroin or other illicit drug use . The majority ( 85 % ) of the buprenorphine patients transferred to alternate-day dosing were maintained in alternate-day dosing . CONCLUSIONS Buprenorphine did not differ from methadone in its ability to suppress heroin use , but retained approximately 10 % fewer patients . This poorer retention was due possibly to too-slow induction onto buprenorphine . For the majority of patients , buprenorphine can be administered on alternate days BACKGROUND Buprenorphine is a partial agonist at the mu-opioid receptor that has been proposed as an alternative to traditional full agonist maintenance therapy for the treatment of opioid addiction . We report on a clinical trial in which the relative safety and efficacy of long-term fixed-dose buprenorphine maintenance was examined in comparison to low- and high-dose methadone maintenance . METHODS Two hundred twenty-five treatment-seeking opioid addicts ( 46 women , 179 men ) were r and omly assigned to receive , in a double-blind manner , either 8 mg/d of buprenorphine , 30 mg/d of methadone , or 80 mg/d of methadone maintenance over a 1-year period . Objective and subjective measures of efficacy ( urine toxicology , retention , craving , and withdrawal symptoms ) were examined at the study midpoint and at termination , and safety data were tabulated over the entire 52-week study period . RESULTS Patients assigned to high-dose methadone maintenance performed significantly better on measures of retention , opioid use , and opioid craving than either the low-dose methadone or the buprenorphine group at both 26-week and 52-week time points . Performance on these measures was virtually identical between the latter two groups . No serious adverse health effects attributable to buprenorphine were noted . CONCLUSIONS Buprenorphine maintenance at 8 mg/d appears to be less than optimally efficacious under the conditions of the present study . Continued research is needed to reconcile these findings with the more positive results reported by other investigative groups . There are no apparent health risks associated with long-term buprenorphine maintenance at this dosage Buprenorphine was evaluated for its abuse potential and utility in treating narcotic addiction . The drug was morphine-like but was 25 to 50 times more potent than morphine and was longer-acting . Little if any physical dependence of clinical significance was produced by buprenorphine . The effects of morphine to 120-mg doses were blocked by buprenorphine , a blockade that persisted for 29 1/2 hours . In man , buprenorphine has less intrinsic activity than morphine , and as such , as a low abuse potential . Moreover , the drug has potential for treating narcotic addiction since it is acceptable to addicts , is long-acting , produces a low level of physical dependence such that patients may be easily detoxified , is less toxic than drugs used for maintenance therapy , and 
    Output:
    
High dose buprenorphine does not retain more patients than low dose methadone  , but may suppress heroin use better .
REVIEW ER 'S CONCLUSIONS Buprenorphine is an effective intervention for use in the maintenance treatment of heroin dependence , but it is not more effective than methadone at adequate dosages