Comparing quality of life methadone and buprenorphine for opioid substitution treatment in Iran

Opioid use disorder (OUD) is a significant global health issue, with harm reduction strategies like Opioid Substitution Treatment (OST) playing a crucial role in improving quality of life (QoL) for affected individuals. In Iran, Methadone Maintenance Treatment (MMT) and Buprenorphine Maintenance Treatment (BMT) have been implemented for over two decades. This study aims to compare the QoL outcomes between these two treatment modalities among opioid-dependent individuals in three outpatient OST clinics. The World Health Organization Quality of Life - Brief Version (WHOQOL-BREF) questionnaire was utilized to evaluate QoL in domains of physical health, psychological health, social relationships, environment, and general health. QoL was compared between patients receiving methadone and buprenorphine while considering demographic characteristics and treatment duration. Multivariate linear regression analysis identified factors associated with QoL. The study included 200 participants with a mean age of 42.7, comprising 103 individuals treated with buprenorphine and 97 treated with methadone. Buprenorphine-treated patients were more likely to be married, female, younger, and have shorter treatment durations. Methadone-treated patients reported higher QoL in physical health (P = 0.001) and social relationship (P = 0.002) domains, while buprenorphine-treated patients reported better environmental health (P < 0.001). No significant differences were found in psychological domains. These QoL differences remained significant after adjusting for confounders. Age, marital status, and gender were significantly associated with various QoL dimensions. The findings indicate that methadone patients reported higher QoL in the social and physical domains in comparison with buprenorphine group, which contrasts with previous studies in other countries. These results highlight the potential impact of cultural context on QoL outcomes for individuals with OUD and provide a basis for future research and development of optimized, culturally sensitive treatment strategies within harm reduction frameworks in developing countries.