Background

Use of pharmaceutical opioids (medicines that are used to treat pain) has increased dramatically in some parts of the world since the mid-1990s. With the increased use, there has been increasing numbers of people seeking treatment for dependence (addiction) on pharmaceutical opioids. Currently, most treatment guidelines are based on research that was conducted in people who were dependent on heroin (a highly addictive opioid). This review sought to compare different opioid agonist maintenance treatments (i.e. treatments such as methadone or buprenorphine that are given for at least 30 days to help the person to reduce their unsanctioned drug use) for the treatment of pharmaceutical opioid dependence. We also compared results from maintenance treatment to short term treatments such as detoxification (removal of the drug from the body) or psychological treatments (e.g. talking therapy, counselling). 

Authors' conclusions:
There is  very low‐ to moderate‐certainty evidence supporting the use of maintenance agonist pharmacotherapy for pharmaceutical opioid dependence. Methadone or buprenorphine did not differ on some outcomes, although on the outcomes of retention and self‐reported substance use some results favoured methadone. Maintenance treatment with buprenorphine appears more effective than non‐opioid treatments.

Due to the overall very low‐ to moderate‐certainty evidence and small sample sizes, there is the possibility that the further research may change these findings.