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Table 2 Guidelines available for evaluation of the appropriateness of opioid agonist and antagonist treatments for patients with opioid dependence

From: Opioid substitution and antagonist therapy trials exclude the common addiction patient: a systematic review and analysis of eligibility criteria

Title of guideline

Country

Year

Intervention(s) assessed

Outcome

Clinical trial design characteristics in supporting evidence

Use of observational studies

Meta-analyses included individual risk of bias assessment

Clinical practice guideline for management of substance use disorders (SUD) [13]

USA

2009

Methadone and buprenorphine

Decrease in opioid use (relapse prevention)

Explanatory by design with strict eligibility criteria

No

Yes, but no discussion of severe limitations of included trials (allocation concealment)

Clinical practice guideline for management of substance use disorders (SUD) [13]

USA

2009

Methadone and buprenorphine

Retention in treatment

Explanatory by design with strict eligibility criteria

No

No discussion of poor methodological quality of included trials and estimate suffers from imprecision

Clinical practice guideline for management of substance use disorders (SUD) [13]

USA

2009

Naltrexone

Decrease in opioid use (relapse prevention) and retention

Explanatory trials by design with strict eligibility criteria used within meta-analysis

No

Meta-analyses provided (two with proper risk of bias assessment)

Buprenorphine/naloxone treatment for opioid dependence clinical practice guidelines [14]

Canada

2011

Buprenorphine/naloxone

Decrease in opioid use (relapse prevention) and retention

Explanatory trials by design with strict eligibility criteria used within meta-analysis and cited trials

Yes, retrospective chart review and patient registry databases

Yes

Methadone maintenance treatment program standards and clinical guidelines [12]

Canada

2011

Methadone maintenance treatment

Decrease in opioid use (relapse prevention)

Explanatory trials by design with strict eligibility criteria used within meta-analysis and cited trials

Yes

No discussion of methodology of included trials used to inform recommendations. Systematic review meta-analyses are cited.

Methadone and buprenorphine for the management of opioid dependence [52]

UK

2007

Methadone and buprenorphine

Decrease in opioid use (relapse prevention) and retention

Explanatory trials by design with strict eligibility criteria used within meta-analysis and cited trials

Yes, provide evidence from systematic reviews of trials and non-randomized studies

Yes (with discussion of methodological limitations)

Guidelines for the psychosocially assisted pharmacological treatment of opioid dependence [53]

International guidelines

2009

All pharmacological therapies for opioid dependence

Decrease in opioid use, treatment retention

Explanatory trials by design with strict eligibility criteria used within meta-analysis and cited trials

Yes, provide evidence from systematic reviews of trials and non-randomized studies

Yes (with discussion of methodological limitations)