REPORTED PREFERENCE OF IVDUs FOR BUPRENORPHINE OVER METHADONE:
A colleague has advise that in Australia there is an extremely high preference for buprenorphine over methadone among potential patients - 9:1! I'm a firm believer in ensuring availability of ANYTHING that offers help and hope to those who want it, which is why I have been enthusiastic in praise of France bringing some 100,000 people into treatment - overwhelmingly with buprenorphine - in precisely the way I've been ecstatic about Germany achieving much the same with methadone. If Russia (estimated opiate dependent population in the millions, essentially zero treatment of any kind available!) were some day to boast a few hundred thousand ivdu's in treatment I could care less if it was with one medication or the other.
BUT I do have concerns over what underlies the preference, and if it is a false expectation, then sooner or later it will haunt us. Specifically, if heroin addicts (and doctors, and politicians, and the voting public) see in buprenorphine a medication that "cures" - that can be taken for a while and then stopped and lasting asbtinence subsequently be the rule rather than exception, it's only a matter of time ...(I say this based on my belief that there's never been a study of post-buprenorphine sustained abstinence - I may have overlooked something).
I am painfully reminded of the first public media discussion of methadone in late 60s (just before my time) where it was described as the "Cinderalla drug" and heralded as a magic panacea that would end addiction in our time (only a tiny bit over-stated). Could probably find the reference if someone wanted it.
Anyone consider a disinterested party doing a focus group and reporting what heroin users prefer, and why . . . ? Would be fascinating, especially if comparing land of Oz with US, Canada, France, etc.