Comparing buprenorphine, methadone and naltrexone in reducing the relapse and harm for people with opioid addiction

A systematic review comparing buprenorphine, methadone, and naltrexone in preventing relapse and promoting harm reduction among people with opioid addiction found that:

• Methadone is considered the gold standard in MAT and can be started at any withdrawal stage. It requires titration to effective dose, which can be time-consuming and must be administered in specialized clinics.
• Buprenorphine is the second most effective Medication-Assisted Treatment (MAT) for reducing harm and preventing relapse. It can be initiated and maintained in primary care settings, has low overdose risk but requires initiation during moderate withdrawal phase.
• Naltrexone (Extended-Release, Intramuscular) in its oral form is ineffective due to low adherence, while the injectable extended-release form shown to reduce relapse and improve quality of life, but it requires 7–14 days of opioid abstinence before initiation.