Trial reportSubstance abuse treatment, prevention, and policy2009
The Leeds Evaluation of Efficacy of Detoxification Study (LEEDS) prisons project: a randomised controlled trial comparing dihydrocodeine and buprenorphine for opiate detoxification.
Trial report in Substance abuse treatment, prevention, and policy, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 9 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 9 syntheses or guidelines pooled it, 92 citations in OpenAlex.
- Evidence-based consensus guidelines for the pharmacological management of substance dependence: Recommendations from the British Association for Psychopharmacology.Journal of psychopharmacology (Oxford, England) · 2026Guideline
- A Systematic Review of Substance Misuse Treatment Processes and Outcomes as Implemented in Prisons for Men in the UK.Criminal behaviour and mental health : CBMH · 2025Pooled it
- Dihydrocodeine for detoxification and maintenance treatment in individuals with opiate use disorders.The Cochrane database of systematic reviews · 2020Pooled it
- Interventions for female drug-using offenders.The Cochrane database of systematic reviews · 2019Pooled it
- Opioid-related treatment, interventions, and outcomes among incarcerated persons: A systematic review.PLoS medicine · 2019Pooled it
- Buprenorphine for managing opioid withdrawal.The Cochrane database of systematic reviews · 2017Pooled it
- Pharmacological interventions for drug-using offenders.The Cochrane database of systematic reviews · 2015Pooled it
- A systematic review of randomized controlled trials of interventions to improve the health of persons during imprisonment and in the year after release.American journal of public health · 2015Pooled it
- Comparison of methadone and buprenorphine for opiate detoxification (LEEDS trial): a randomised controlled trial.The British journal of general practice : the journal of the Royal College of General Practitioners · 2011Pooled it
- Methods for delivering the UK's multi-centre prison-based naloxone-on-release pilot randomised trial (N-ALIVE): Europe's largest prison-based randomised controlled trial.Drug and alcohol review · 2018Trial
- A stepped wedge cluster randomized control trial of dried blood spot testing to improve the uptake of hepatitis C antibody testing within UK prisons.European journal of public health · 2015Trial
- Interventions for drug-using offenders with co-occurring mental health problems.The Cochrane database of systematic reviews · 2019Review
- Mental health of prisoners: prevalence, adverse outcomes, and interventions.The lancet. Psychiatry · 2016Review
- Newer approaches to opioid detoxification.Industrial psychiatry journal · 2012Article
- Deaths of opiate/opioid misusers involving dihydrocodeine, UK, 1997-2007.British journal of clinical pharmacology · 2011Article
- Drug use and opioid substitution treatment for prisoners.Harm reduction journal · 2010Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMany opiate users entering British prisons require prescribed medication to help them achieve abstinence. This commonly takes the form of a detoxification regime. Previously, a range of detoxification agents have been prescribed without a clear evidence base to recommend a drug of choice. There are few trials and very few in the prison setting. This study compares dihydrocodeine with buprenorphine.
methodsOpen label, pragmatic, randomised controlled trial in a large remand prison in the North of England. Ninety adult male prisoners requesting an opiate detoxification were randomised to receive either daily sublingual buprenorphine or daily oral dihydrocodeine, given in the context of routine care. All participants gave written, informed consent. Reducing regimens were within a standard regimen of not more than 20 days and were at the discretion of the prescribing doctor. Primary outcome was abstinence from illicit opiates as indicated by a urine test at five days post detoxification. Secondary outcomes were collected during the detoxification period and then at one, three and six months post detoxification. Analysis was undertaken using relative risk tests for categorical data and unpaired t-tests for continuous data.
results64% of those approached took part in the study. 63 men (70%) gave a urine sample at five days post detoxification. At the completion of detoxification, by intention to treat analysis, a higher proportion of people allocated to buprenorphine provided a urine sample negative for opiates (abstinent) compared with those who received dihydrocodeine (57% vs 35%, RR 1.61 CI 1.02-2.56). At the 1, 3 and 6 month follow-up points, there were no significant differences for urine samples negative for opiates between the two groups. Follow up rates were low for those participants who had subsequently been released into the community.
conclusionThese findings would suggest that dihydrocodeine should not be routinely used for detoxification from opiates in the prison setting. The high relapse rate amongst those achieving abstinence would suggest the need for an increased emphasis upon opiate maintenance programmes in the prison setting.
trial registrationCurrent Controlled Trials ISRCTN07752728.
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