title: Treatment of heroin dependence with buprenorphine in primary care.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520-8025, USA. david.fiellin@yale.edu
authors.forename: David A
authors.initials: DA
authors.lastname: Fiellin
authors.forename: Michael V
authors.initials: MV
authors.lastname: Pantalon
authors.forename: Juliana P
authors.initials: JP
authors.lastname: Pakes
authors.forename: Patrick G
authors.initials: PG
authors.lastname: O'Connor
authors.forename: Marek
authors.initials: M
authors.lastname: Chawarski
authors.forename: Richard S
authors.initials: RS
authors.lastname: Schottenfeld
mesh_terms: 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
chemical_list: D002047:Buprenorphine