| "NEW YORK (Reuters Health) - For the treatment of heroin addiction, "stepped treatment" with Suboxone tablets, which contain a combination of buprenorphine and naloxone known to combat drug cravings, followed by escalation to methadone if needed, appears to work as well as methadone maintenance therapy, according to US and Swedish researchers." ""The most important conclusion of the study," senior investigator Dr. Markus Heilig told Reuters Health, "is that it is safe and effective to offer all heroin-dependent patients Suboxone as the first line of treatment."" ""Methadone, which can be more effective but at the cost of being less safe, should be reserved for patients who do not do well on Suboxone," Heilig said. " "Heilig, of the National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland and colleagues studied 96 "self-referred" heroin addicts who came in for treatment. They were randomly assigned to traditional methadone or to stepped treatment initiated with Suboxone and switching to methadone if needed. All subjects also received intensive behavioral treatment." "At 6 months, 78 percent remained in treatment. According to the team, the outcomes with stepped treatment starting with Suboxone and methadone maintenance therapy were "virtually identical." Of those who completed stepped therapy, 46 percent remained on Suboxone." "The proportion of urine samples free of illicit opiates increased over time and ultimately reached approximately
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