{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:57:20Z","timestamp":1790708240278,"version":"4.1.0"},"reference-count":47,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,1,19]],"date-time":"2014-01-19T00:00:00Z","timestamp":1390089600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To compare the efficacy of slow\u2010release oral morphine (<jats:styled-content style=\"fixed-case\">SROM<\/jats:styled-content>) and methadone as maintenance medication for opioid dependence in patients previously treated with methadone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective, multiple\u2010dose, open label, randomized, non\u2010inferiority, cross\u2010over study over two 11\u2010week periods. Methadone treatment was switched to <jats:styled-content style=\"fixed-case\">SROM<\/jats:styled-content> with flexible dosing and vice versa according to period and sequence of treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Fourteen out\u2010patient addiction treatment centres in <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>witzerland and <jats:styled-content style=\"fixed-case\">G<\/jats:styled-content>ermany.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Adults with opioid dependence in methadone maintenance programmes (dose \u226550\u2009mg\/day) for \u226526 weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>The efficacy end\u2010point was the proportion of heroin\u2010positive urine samples per patient and period of treatment. Each week, two urine samples were collected, randomly selected and analysed for 6\u2010monoacetyl\u2010morphine and 6\u2010acetylcodeine. Non\u2010inferiority was concluded if the two\u2010sided 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) in the difference of proportions of positive urine samples was below the predefined boundary of 10%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>One hundred and fifty\u2010seven patients fulfilled criteria to form the per protocol population. The proportion of heroin\u2010positive urine samples under <jats:styled-content style=\"fixed-case\">SROM<\/jats:styled-content> treatment (0.20) was non\u2010inferior to the proportion under methadone treatment (0.15) (least\u2010squares mean difference 0.05; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u2009=\u20090.02, 0.08; <jats:italic>P<\/jats:italic>\u2009&gt;\u20090.01). The 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> fell within the 10% non\u2010inferiority margin, confirming the non\u2010inferiority of <jats:styled-content style=\"fixed-case\">SROM<\/jats:styled-content> to methadone. A dose\u2010dependent effect was shown for <jats:styled-content style=\"fixed-case\">SROM<\/jats:styled-content> (i.e. decreasing proportions of heroin\u2010positive urine samples with increasing <jats:styled-content style=\"fixed-case\">SROM<\/jats:styled-content> doses). Retention in treatment showed no significant differences between treatments (period 1\/period 2: <jats:styled-content style=\"fixed-case\">SROM<\/jats:styled-content>: 88.7%\/82.1%, methadone: 91.1%\/88.0%; period 1: <jats:italic>P<\/jats:italic>\u2009=\u20090.50, period 2: <jats:italic>P<\/jats:italic>\u2009=\u20090.19). Overall, safety outcomes were similar between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Slow\u2010release oral morphine appears to be at least as effective as methadone in treating people with opioid use disorder.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.12440","type":"journal-article","created":{"date-parts":[[2013,12,4]],"date-time":"2013-12-04T13:14:26Z","timestamp":1386162866000},"page":"617-626","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":91,"title":["Maintenance treatment for opioid dependence with slow\u2010release oral morphine: a randomized cross\u2010over, non\u2010inferiority study versus methadone"],"prefix":"10.1111","volume":"109","author":[{"given":"Thilo","family":"Beck","sequence":"first","affiliation":[{"name":"Arud Centres for Addiction Medicine  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Haasen","sequence":"additional","affiliation":[{"name":"Centre for Interdisciplinary Addiction Research of Hamburg University Department of Psychiatry University Medical Centre Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Verthein","sequence":"additional","affiliation":[{"name":"Centre for Interdisciplinary Addiction Research of Hamburg University Department of Psychiatry University Medical Centre Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Walcher","sequence":"additional","affiliation":[{"name":"Concept Schwerpunktpraxis Sucht  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Schuler","sequence":"additional","affiliation":[{"name":"Praxis Turmstrasse  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Backmund","sequence":"additional","affiliation":[{"name":"Praxiszentrum im Tal  Munich Germany"},{"name":"Ludwig\u2010Maximilians\u2010Universit\u00e4t  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Ruckes","sequence":"additional","affiliation":[{"name":"Interdisciplinary Centre for Clinical Trials (IZKS) University Medical Centre of the Johannes Gutenberg University Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Reimer","sequence":"additional","affiliation":[{"name":"Centre for Interdisciplinary Addiction Research of Hamburg University Department of Psychiatry University Medical Centre Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,1,19]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"World Health Organization\/United Nations Office on Drugs and Crime\/Joint United Nations Programme on HIV\/AIDS (WHO\/UNDOC\/UNAIDS).WHO\/UNDOC\/UNAIDS position paper.2004. 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