Injectable diacetylmorphine is more effective than oral methadone in the treatment of chronic relapsing opioid dependence
Bibliographic record
Abstract
Injectable diacetylmorphine is more effective than oral methadone in the treatment of chronic relapsing opioid dependence QUESTION Question: Is injectable diacetylmorphine more effective than oral methadone maintenance therapy in patients with opioid dependence that is refractory to treatment?Patients: Users of injectable heroin for at least 5 years, aged 25 years or older who had not responded to at least two previous attempts at treatment for addiction (including at least one methadone treatment, undertaken at least 6 months prior to the study).Exclusions: medical or psychiatric conditions that are contraindications for diacetylmorphine (diamorphine), pregnancy, involvement with the criminal justice system which may have resulted in incarceration during the study period.Setting: Montreal, Quebec and Vancouver, British Columbia, from March 2005 to July 2008.Intervention: Oral methadone or injectable diacetylmorphine hydrochloride.Methadone was administered at a clinic or pharmacy on a daily basis; the dosage was based on best practices and current clinical practice guidelines.The diacetylmorphine (diamorphine) was self-administered under supervision in treatment clinics up to 3 times daily with a maximum daily dose of 1000 mg.Outcomes: The primary outcomes were the rate of retention in treatment and the reduction in illicit drug use or other illegal activities at 3, 6, 9 and 12 months after baseline evaluation.Response at 12 months was defi ned as an improvement of at least 20% from the baseline score for illicit-drug use or legal status (or both).Patient follow up: 41% methadone, 67% injectable diacetylmorphine (diamorphine).100% included in the intention-totreat analysis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.015 | 0.006 |
| Insufficient payload (model declined to judge) | 0.008 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".