From the Research
Methadone is the most effective treatment for opioid use disorder, with the strongest evidence for effectiveness, and should be considered as the first-line treatment. When considering treatment options for opioid use disorder, it is essential to prioritize medications that have demonstrated efficacy in reducing morbidity, mortality, and improving quality of life. According to the study published in Biological Psychiatry 1, methadone has the strongest evidence for effectiveness, and its use is associated with better outcomes, including restoration of social connections.
The study published in Seminars in Neurology 2 provides a comprehensive review of opioid maintenance therapy, including methadone, buprenorphine, and naltrexone, and highlights the importance of considering patient characteristics and preferences when choosing a treatment. However, the most recent and highest-quality study, published in 2020, emphasizes the effectiveness of methadone 1.
Some may argue that buprenorphine or naltrexone could be considered as alternative treatment options, but the evidence suggests that methadone is the most effective treatment, particularly for patients at higher risk of treatment dropout, such as injection opioid users 3. Additionally, the study published in The American Journal of Drug and Alcohol Abuse 4 suggests that cognitive-behavioral therapy may be beneficial when added to buprenorphine therapy, but this does not change the fact that methadone is the most effective treatment for opioid use disorder.
It is also important to consider the reasons why individuals start and stop medication-assisted treatment, as highlighted in the study published in the Journal of Addiction Medicine 5. However, this does not alter the fact that methadone is the most effective treatment for opioid use disorder and should be considered as the first-line treatment.
In terms of treatment strategies, it is essential to prioritize patient-centered care, considering individual characteristics and preferences, and to provide access to medication-assisted treatment, including methadone, to reduce morbidity, mortality, and improve quality of life. The use of methadone as a first-line treatment for opioid use disorder is supported by the strongest evidence and should be prioritized in clinical practice.