Opioid agonist treatment – which one?

This is the write up of the session ‘Opioid agonist treatment – which one?’ from day 1 of the INHSU 2021 conference. 


The risk of death without opioid agonist treatment was more than twice than seen with opioid agonist treatment. These results came from a systematic review and meta-analysis conducted by Thomas Santo Jr and others. 

Michael Farrell from the National Drug and Alcohol Research Centre provided an overview of the results from the COLAB study, of people receiving 48 weeks of extended-release buprenorphine treatment in diverse community healthcare settings in Australia. Most participants (83 per cent) reported they were extremely or very satisfied with the treatment. The majority transferred successfully from oral to depot buprenorphine with high retention over the first 48 weeks of treatment.  

Adrian Dunlop, Drug & Alcohol Clinical Services, Hunter New England Health presented a summary of the results from the UNLOC-T trial. This study assessed the safety of depot buprenorphine in seven correctional centres in New South Wales, Australia. Retention with depot buprenorphine treatment was 92 per cent. Patient satisfaction scores were high (82.18/100). Adrian added, “There has been lots of positive feedback from prison officers.” Watch this space… there is a study to be released that will compare methadone with depot buprenorphine.  

Louisa Degenhardt, National Drug and Alcohol Research Centre, Australia, discussed highlights from the PREFER study. The motivation for this study was to uncover the role of patient choice. Despite extended-release buprenorphine having the potential to transform opioid agonist treatment, 54 per cent and 34 per cent of participants indicated a preference for methadone and buprenorphine, respectively. Among those with a preference for injectable buprenorphine, half still preferred to receive sublingual buprenorphine. This is an important take-away message when scaling up the availability of extended-release buprenorphine. 

This important topic is related to an upcoming INHSU project, called ‘My Choice: Supporting person-centred choice in determining drug treatment options for people with opioid dependence’. My Choice is a participatory storytelling project designed to support people-centred choice in the delivery of opioid substitution therapy services. The project seeks to show diverse experiences of opioid dependence, emphasise the importance of personal choice in choosing interventions and to demonstrate that drug treatment is most effective when we respect the individual needs of an informed population.