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The practice of office-based buprenorphine treatment of opioid dependence: is it associated with new patients entering into treatment?

Abstract：

:Office-based buprenorphine holds the promise of bringing patients who have never received pharmacotherapy into treatment. In a cross-sectional and longitudinal analysis, we compared patients entering a clinical trial of buprenorphine in a Primary Care Clinic (PCC) and those entering a local Opioid Treatment Program (OTP) and we compared the clinical characteristics and treatment outcomes of PCC patients with no history of methadone treatment (new-to-treatment) to those with prior methadone treatment. PCC subjects (N=96) were enrolled in a 26-week randomized clinical trial of office-based buprenorphine/naloxone provided in a PCC. OTP subjects (N=94) were enrolled in methadone maintenance during the same time period. PCC subjects compared with OTP subjects were more likely to be male (77% versus 55%, p<0.01), full-time employed (46% versus 15%, p<0.001), have no history of methadone treatment (46% versus 61%, p<0.05), have fewer years of opioid dependence (10 versus 15, p<0.001), and lower rates of injection drug use (IDU) (44% versus 60%, p=0.03). The new-to-treatment PCC subjects were younger (36 years versus 41 years, p=0.001), more likely to be white (77% versus 57%, p=0.04), had fewer years of opioid dependence (7 versus 14, p<0.001), were less likely to have a history of IDU (35% versus 54%, p=0.07), and had lower rates of hepatitis C (25% versus 61%, p=0.002) than subjects with prior methadone treatment. Abstinence and treatment retention were comparable in both groups. The results suggest that office-based treatment of opioid dependence is associated with new types of patients entering into treatment. Treatment outcomes with buprenorphine in a PCC do not vary based on history of prior methadone treatment.

journal_name

Drug Alcohol Depend

journal_title

Drug and alcohol dependence

authors

Sullivan LE,Chawarski M,O'Connor PG,Schottenfeld RS,Fiellin DA

doi

10.1016/j.drugalcdep.2004.12.008

keywords:

subject

Has Abstract

pub_date

2005-07-01 00:00:00

pages

113-6

issue

eissn

0376-8716

issn

1879-0046

pii

S0376-8716(05)00016-5

journal_volume

pub_type

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The practice of office-based buprenorphine treatment of opioid dependence: is it associated with new patients entering into treatment?