Do methadone and buprenorphine have the same impact on psychopathological symptoms of heroin addicts?

Drug addiction history was collected by means of the Drug Addiction History Rating Scale (DAH-RS) and psychopathological features were collected by means of the Symptom Checklist-90 (SCL-90), using a special five-factor solution. Toxicological urinalyses were carried out for each patient during the treatment period.No statistically significant differences were detected in psychopathological symptoms, including 'worthlessness-being trapped', 'somatization', and 'panic-anxiety'. Methadone proved to be more effective on patients characterized by 'sensitivity-psychoticism', whereas buprenorphine was more effective on patients displaying a 'violence-suicide' symptomatology.Heroin-dependent patients with psychiatric comorbidities may benefit from opioid agonist treatment not only because it targets their addictive problem, but also, precisely due to this, because it is effective against their mental disorder too.While psychiatric comorbidity has been shown to have a negative impact on the outcome of opioid use disorders [1-9], studies carried out in the context of Methadone Maintenance Treatment Programs (MMTPs) to evaluate outcomes strictly linked with methadone efficacy have not demonstrated any such negative influence [10-14].The complex nature of psychopathology in substance abuse disorders (SUDs), is particularly difficult to assess at the moment of admission to treatment, when the heterogeneity of the psychological/psychiatric conditions displayed impairs the attribution of symptoms to psychiatric conditions preceding the initial use of substances, to the effects of heroin and/or other substances, to neurobiological addictive processes, or to psychosocial stress associated with addictive behavior [15-18]. On these bases a unitary perspective has been proposed, foreseeing the inclusion of symptoms of anxiety, mood and impulse-control domains in the psychopathology of addiction, but also taking into account symptoms and syndromes that are under the threshold for the d