Trial reportAddiction (Abingdon, England)2014
Maintenance treatment for opioid dependence with slow-release oral morphine: a randomized cross-over, non-inferiority study versus methadone.
Trial report in Addiction (Abingdon, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01079117 (Randomised, Controlled Clinical Study Regarding the Feasibility of Converting Opiate Dependents From Methadone Substitutes to Slow Release Morphine Sulphate), which is not on this map. Cited by 34 papers, 3 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.
Randomised, Controlled Clinical Study Regarding the Feasibility of Converting Opiate Dependents From Methadone Substitutes to Slow Release Morphine Sulphate (Sevre-Long™)
Who cites it
34 citing papers in PubMed, 3 syntheses or guidelines pooled it, 98 citations in OpenAlex.
- Pooled it
- Slow release oral morphine versus methadone for the treatment of opioid use disorder.BMJ open · 2019Pooled it
- Management of opioid use disorders: a national clinical practice guideline.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2018Guideline
- Dose-dependent naloxone-induced morphine withdrawal symptoms in opioid-dependent males-a double-blinded, randomized study.British journal of clinical pharmacology · 2020Trial
- Real-world comparative effects of slow-release oral morphine vs. methadone on healthcare use for opioid use disorder: A population-based target trial emulation.Addiction (Abingdon, England) · 2026Article
- Self-Adapting Priors for Dynamic Borrowing in Three-Arm Non-Inferiority Trials With Pre-Specified Margin.Statistics in medicine · 2026Article
- Slow-Release Oral Morphine vs Methadone for Opioid Use Disorder in the Fentanyl Era.JAMA network open · 2026Article
- Buprenorphine Oral Lyophilisate for Treatment of Opioid Use Disorder: Pharmacology and Clinical Efficacy.Pharmaceuticals (Basel, Switzerland) · 2026Review
- Adapting opioid therapy: real-world analysis of switching from methadone to slow-release morphine and back amid COVID-19 supply chain disruptions.Addiction science & clinical practice · 2026Article
- Opioid medication doses among safer supply clients: Current safer supply doses and previous OAT experience.Drug and alcohol dependence reports · 2025Article
- Navigating new norms: Addiction specialists' perspectives on opioid use disorder treatments and policy challenges in the fentanyl era.The American journal on addictions · 2025Article
- [Challenges in the treatment of opioid dependence].Der Nervenarzt · 2024Review
- Breaking barriers: Supporting a syndemics approach to hepatitis C elimination.The International journal on drug policy · 2024Article
- Initiation and rapid titration of methadone and slow-release oral morphine (SROM) in an acute care, inpatient setting: a case series.European journal of medical research · 2023Article
- Clients' experiences on North America's first take-home injectable opioid agonist treatment (iOAT) program: a qualitative study.BMC health services research · 2023Article
- Heroin and its metabolites: relevance to heroin use disorder.Translational psychiatry · 2023Review
- Uptake of slow-release oral morphine as opioid agonist treatment among hospitalised patients with opioid use disorder.Drug and alcohol review · 2022Article
- Oral Morphine as an Alternative Substitution Treatment for Opioid Use Disorder, a Rare but Non-risk-free Use.Frontiers in psychiatry · 2022Article
- Feasibility of Testing Client Preferences for Accessing Injectable Opioid Agonist Treatment (iOAT): A Pilot Study.Patient preference and adherence · 2022Article
- Outcomes of Ottawa, Canada's Managed Opioid Program (MOP) where supervised injectable hydromorphone was paired with assisted housing.The International journal on drug policy · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo compare the efficacy of slow-release oral morphine (SROM) and methadone as maintenance medication for opioid dependence in patients previously treated with methadone.
designProspective, multiple-dose, open label, randomized, non-inferiority, cross-over study over two 11-week periods. Methadone treatment was switched to SROM with flexible dosing and vice versa according to period and sequence of treatment.
settingFourteen out-patient addiction treatment centres in Switzerland and Germany.
participantsAdults with opioid dependence in methadone maintenance programmes (dose ≥50 mg/day) for ≥26 weeks. MEASUREMENTS: The efficacy end-point was the proportion of heroin-positive urine samples per patient and period of treatment. Each week, two urine samples were collected, randomly selected and analysed for 6-monoacetyl-morphine and 6-acetylcodeine. Non-inferiority was concluded if the two-sided 95% confidence interval (CI) in the difference of proportions of positive urine samples was below the predefined boundary of 10%.
findingsOne hundred and fifty-seven patients fulfilled criteria to form the per protocol population. The proportion of heroin-positive urine samples under SROM treatment (0.20) was non-inferior to the proportion under methadone treatment (0.15) (least-squares mean difference 0.05; 95% CI = 0.02, 0.08; P > 0.01). The 95% CI fell within the 10% non-inferiority margin, confirming the non-inferiority of SROM to methadone. A dose-dependent effect was shown for SROM (i.e. decreasing proportions of heroin-positive urine samples with increasing SROM doses). Retention in treatment showed no significant differences between treatments (period 1/period 2: SROM: 88.7%/82.1%, methadone: 91.1%/88.0%; period 1: P = 0.50, period 2: P = 0.19). Overall, safety outcomes were similar between the two groups.
conclusionsSlow-release oral morphine appears to be at least as effective as methadone in treating people with opioid use disorder.
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Registered trials
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