SynthesisThe Cochrane database of systematic reviews2013
Methadone at tapered doses for the management of opioid withdrawal.
Synthesis in The Cochrane database of systematic reviews, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 10 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
44 citing papers in PubMed, 10 syntheses or guidelines pooled it, 218 citations in OpenAlex.
- Barriers and facilitators to detoxification from opioid substitution treatment: A mixed-methods systematic review.Addiction (Abingdon, England) · 2026Pooled it
- 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
- Global patterns of opioid use and dependence: harms to populations, interventions, and future action.Lancet (London, England) · 2019Pooled it
- Management of opioid use disorders: a national clinical practice guideline.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2018Guideline
- Needle syringe programmes and opioid substitution therapy for preventing hepatitis C transmission in people who inject drugs.The Cochrane database of systematic reviews · 2017Pooled it
- Pharmacological interventions for drug-using offenders.The Cochrane database of systematic reviews · 2015Pooled it
- Discontinuation of buprenorphine maintenance therapy: perspectives and outcomes.Journal of substance abuse treatment · 2015Pooled it
- Detoxification treatments for opiate dependent adolescents.The Cochrane database of systematic reviews · 2014Pooled it
- Comparative effectiveness of alternative times to opioid agonist treatment taper initiation on taper completion and all-cause mortality among people with opioid use disorder: A retrospective population-based target trial emulation study in British Columbia, Canada, 2010-2020.Addiction (Abingdon, England) · 2026Observational
- Bed-based care as a response to the overdose crisis: an approach to informing and evaluating proposed expansion.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025Article
- Associations Among Sleep, Pain, and Medications for Opioid Use Disorder: a Scoping Review.Current addiction reports · 2024Article
- Opioid-specific harm reduction in the emergency department: how staff provide harm reduction and contextual factors that impact their capacity to engage in harm reduction practice.Harm reduction journal · 2024Article
- Prevalence and correlates of DSM-5 opioid withdrawal syndrome in U.S. adults with non-medical use of prescription opioids: results from a national sample.The American journal of drug and alcohol abuse · 2023Article
- How an emergency department is organized to provide opioid-specific harm reduction and facilitators and barriers to harm reduction implementation: a systems perspective.Harm reduction journal · 2023Article
- Spatial access to buprenorphine-waivered prescribers in the HEALing communities study: Enhanced 2-step floating catchment area analyses in Massachusetts, Ohio, and Kentucky.Journal of substance use and addiction treatment · 2023Article
- Hallucinogenic potential: a review of psychoplastogens for the treatment of opioid use disorder.Frontiers in pharmacology · 2023Review
- Historical Pathways for Opioid Addiction, Withdrawal with Traditional and Alternative Treatment Options with Ketamine, Cannabinoids, and Noribogaine: A Narrative Review.Health psychology research · 2022Article
- Prevalence and correlates of non-fatal overdose among people who use drugs: findings from rapid assessments in Massachusetts, 2017-2019.Harm reduction journal · 2021Article
Corrections and comments
- Update of
Authors and funding
6 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe evidence of tapered methadone's efficacy in managing opioid withdrawal has been systematically evaluated in the previous version of this review that needs to be updated
objectivesTo evaluate the effectiveness of tapered methadone compared with other detoxification treatments and placebo in managing opioid withdrawal on completion of detoxification and relapse rate. SEARCH
methodsWe searched: Cochrane Central Register of Controlled Trials (The Cochrane Library 2012, Issue 4), PubMed (January 1966 to May 2012), EMBASE (January 1988 to May 2012), CINAHL (2003- December 2007), PsycINFO (January 1985 to December 2004), reference lists of articles. SELECTION CRITERIA: All randomised controlled trials that focused on the use of tapered methadone versus all other pharmacological detoxification treatments or placebo for the treatment of opiate withdrawal. DATA COLLECTION AND ANALYSIS: Two review authors assessed the included studies. Any doubts about how to rate the studies were resolved by discussion with a third review author. Study quality was assessed according to the criteria indicated in the Cochrane Handbook for Systematic Reviews of Interventions. MAIN
resultsTwenty-three trials involving 2467 people were included. Comparing methadone versus any other pharmacological treatment, we observed no clinical difference between the two treatments in terms of completion of treatment, 16 studies 1381 participants, risk ratio (RR) 1.08 (95% confidence interval (CI) 0.97 to 1.21); number of participants abstinent at follow-up, three studies, 386 participants RR 0.98 (95% CI 0.70 to 1.37); degree of discomfort for withdrawal symptoms and adverse events, although it was impossible to pool data for the last two outcomes. These results were confirmed also when we considered the single comparisons: methadone with: adrenergic agonists (11 studies), other opioid agonists (eight studies), anxiolytic (two studies), paiduyangsheng (one study). Comparing methadone with placebo (two studies) more severe withdrawal and more drop-outs were found in the placebo group. The results indicate that the medications used in the included studies are similar in terms of overall effectiveness, although symptoms experienced by participants differed according to the medication used and the program adopted. AUTHORS'
conclusionsData from literature are hardly comparable; programs vary widely with regard to the assessment of outcome measures, impairing the application of meta-analysis. The studies included in this review confirm that slow tapering with temporary substitution of long- acting opioids, can reduce withdrawal severity. Nevertheless, the majority of patients relapsed to heroin use.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.