Treatment of heroin dependence with buprenorphine in primary care.
Buprenorphine is an effective treatment for heroin dependence. The feasibility and potential efficacy of buprenorphine with brief counseling in primary care is unknown. We enrolled 14 heroin dependent patients in a 13-week clinical trial using thrice weekly buprenorphine along with brief counseling in the primary care center of an urban medical center. Primary outcomes included urine toxicology and treatment retention. Opioid-positive urine toxicology tests reduced over the 13-week period from 95 to 25% (p < 0.05). Eleven patients (79%) had greater than or equal to one week of opioid-free urine toxicologies. Nine patients (64%) had greater than or equal to three weeks of opioid-free urine toxicologies. Eleven patients (79%) were retained through the maintenance phase. We conclude that buprenorphine maintenance is feasible in a primary care setting.
Fiellin
David A
DA
Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520-8025, USA. david.fiellin@yale.edu
Pantalon
Michael V
MV
Pakes
Juliana P
JP
O'Connor
Patrick G
PG
Chawarski
Marek
M
Schottenfeld
Richard S
RS
D000286:Administration, Sublingual; D000328:Adult; D000553:Ambulatory Care; D002047:Buprenorphine / Q000008:administration & dosage* / Q000009:adverse effects; D003131:Combined Modality Therapy; D003237:Connecticut; D003376:Counseling; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005240:Feasibility Studies; D005260:Female; D006556:Heroin Dependence / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D012944:Social Support; D016896:Treatment Outcome; D014505:Urban Population
D002047:Buprenorphine