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Evidence-Based Resource Summary

Strength of Evidence: 
4 out of 4
4 out of 4
Year Published: 
2017

Supervised Dosing with a Long-Acting Opioid Medication in the Management of Opioid Dependence

Description of Resource: 
Opioid dependence (OD) is an increasing clinical and public health problem worldwide. International guidelines recommend opioid substitution treatment (OST), such as methadone and buprenorphine, as first-line medication treatment for OD. OST can be abused or sold on the black market. Daily supervised administration of OST may reduce the risk of resale or abuse, but costs more and is more restrictive on the client than dispensing for off-site consumption. This systematic review aimed to compare the effectiveness of OST with supervised dosing relative to dispensing for off-site consumption. It identified 6 studies involving 8,000 participants. At 3 or more months follow-up, this review found no evidence that supervised dosing helps to keep people in treatment or reduce opioid use, mortality, and adverse drug events. More research comparing supervised and take-home medication strategies is needed.

Evidence-Based Resource Details

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Developed By: 
Cochrane Review
Developer Type: 
Non-Federal Government
Healthy People 2020 Topic Area(s): 
Medical Product Safety
Healthy People 2020 Objectives: 
Resource Type: 
Systematic Review
Citation: 
Saulle R, Vecchi S, Gowing L. Supervised dosing with a long-acting opioid medication in the management of opioid dependence. Cochrane Database Syst Rev [Internet]. 2017 [cited 2018 Feb 28];(4). Art. No.: CD011983. doi: 10.1002/14651858.CD011983.pub2. Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011983.pub2/full