Primary Care Office-based Buprenorphine Treatment: Comparison of Heroin and Prescription Opioid Dependent Patients
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Prescription opioid dependence is increasing, but treatment outcomes with office-based buprenorphine/naloxone among these patients have not been described.
We compared demographic, clinical characteristics and treatment outcomes among 200 patients evaluated for entry into a trial of primary care office-based buprenorphine/naloxone treatment stratifying on those who reported exclusive heroin use (n = 124), heroin and prescription opioid use (n = 47), or only prescription opioid use (n = 29).
Compared to heroin-only patients, prescription-opioid-only patients were younger, had fewer years of opioid use, and less drug treatment history. They were also more likely to be white, earned more income, and were less likely to have Hepatitis C antibodies. Prescription-opioid-only patients were more likely to complete treatment (59% vs. 30%), remained in treatment longer (21.0 vs. 14.2 weeks), and had a higher percent of opioid-negative urine samples than heroin only patients (56.3% vs. 39.8%), all p values < .05. Patients who used both heroin and prescription opioids had outcomes that were intermediate between heroin-only and prescription-opioid-only patients.
Individuals dependent on prescription opioids have an improved treatment response to buprenorphine/naloxone maintenance in an office-based setting compared to those who exclusively or episodically use heroin.
KEY WORDSbuprenorphine/therapeutic use primary health care opioid-related disorders
- 1.Office of Applied Studies. Results from the 2003 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 04-3964, NHSDA Series H-25). Rockville, MD: Substance Abuse and Mental Health Services Administration; 2004.Google Scholar
- 9.American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
- 11.Knight K, Halcom M, Simpson DD. TCU psychosocial functioning and motivation scales: Manual on psychometric properties. Institute for Behavioral Research: Texas Christian University; 1994.Google Scholar
- 14.Hosmer DW, Lemeshow S. Applied Logistic Regression. New York: John Wiley & Sons; 2000.Google Scholar
- 15.Fiellin DA, O’Connor PG, Chawarski M, Pantalon MV, Schottenfeld RS. Office versus narcotic treatment program-based buprenorphine for opioid dependence. Drug Alcohol Depend. 2002;66:S55–6.Google Scholar
- 19.McLeod CC, Kissin WB, Stanton A, Sonnefeld J. 30-day outcomes for buprenorphine patients treated by a national sample of qualified physicians. College on Problems of Drug Dependence. Orlando, FL; 2005.Google Scholar