Systematic Literature Review on Buprenorphine/naloxone Use in Outpatient Opioid Dependence Treatment
Bibliographic record
Abstract
Objective: Summarize the literature on buprenorphine/naloxone for outpatient treatment of opioid dependence disorder. Methods: a literature of EMBASE and Medline 2000–2014 using the terms “naloxone + buprenorphine” and “opioid-related disorders”. Results: Over two hundred articles were retrieved. Seventeen studies were ultimately selected and reviewed for study quality, using Downs and Black's 1998 checklist, the Canadian Task Force on Preventive Health Care levels of evidence and study outcome analysis. Conclusion: Buprenorphine/naloxone appears to be a safe, effective treatment modality for treatment of opioid dependence. As a recently introduced medication in North America, clinicians are slow to fully embrace it use. It provides an opportunity to more widely provide opioid substitution therapy in primary care settings. Key words: addiction, opioid substitution therapy, buprenorphine/naloxone, outpatient. Objectif: Résumer la littérature sur l'utilisation de buprenorphine/naloxone pour le traitement ambulatoire des troubles de dépendance aux opioïdes. Méthodes: Recherche des publications disponibles sur EMBASE et Medline entre les années 2000 et 2014 utilisant les mots clés “naloxone + buprenorphine” et “opioid-related disorders”. Résultats: Plus de deux cents articles ont été extraits. Dix-sept études ont finalement été sélectionnées et examinées pour leur qualité en utilisant la grille d’évaluation développée par Downs and Black (1998), l’échelle de classement de la qualité des données probantes du Groupe d’étude canadien sur les soins de santé préventifs et l'analyse des résultats de l’étude. Conclusion: La buprenorphine/naloxone semble être une modalité de traitement sécuritaire et efficace pour le traitement de la dépendance aux opioïdes. Puisque cette médication est nouvellement disponible en Amérique du nord, les cliniciens sont lents à l'adopter dans leur pratique. Elle permet d'offrir à plus grande échelle une thérapie de substitution aux opioïdes dans les milieux de soins primaires. Mots clés: dépendance, thérapie de substitution aux opioïdes, buprénorphine/naloxone, consultation en externe
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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 | 0.008 | 0.037 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.006 |
| Bibliometrics | 0.020 | 0.019 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
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".