title: Influence of psychotherapy attendance on buprenorphine treatment outcome.
abstract: We evaluated the influence of psychotherapy attendance on treatment outcome in 90 dually (cocaine and heroin) dependent outpatients who completed 70 days of a controlled clinical trial of sublingual buprenorphine (16 mg, 8 mg, or 2 mg daily, or 16 mg every other day) plus weekly individual standardized interpersonal cognitive psychotherapy. Treatment outcome was evaluated by quantitative urine benzoylecgonine (BZE) and morphine levels (log-transformed), performed three times per week. Repeated-measures linear regression was used to assess the effects of psychotherapy attendance (percent of visits kept), medication group, and study week on urine drug metabolite levels. Mean psychotherapy attendance was 71% of scheduled visits. Higher psychotherapy attendance was associated with lower urine BZE levels, and this association grew more pronounced as the study progressed (p=0.04). The inverse relationship between psychotherapy attendance and urine morphine levels varied by medication group, being most pronounced for subjects receiving 16 mg every other day (p=0.02). These results suggest that psychotherapy can improve the outcome of buprenorphine maintenance treatment for patients with dual (cocaine and opioid) dependence.
authors.affiliation: Division of Pharmacotherapies and Medical Consequences of Drug Abuse, National Institute on Drug Abuse, National Institutes of Health, Department of Health & Human Services, Rockville, MD 20892, USA. imontoya@mail.nih.gov
authors.forename: Iván D
authors.initials: ID
authors.lastname: Montoya
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Schroeder
authors.forename: Kenzie L
authors.initials: KL
authors.lastname: Preston
authors.forename: Lino
authors.initials: L
authors.lastname: Covi
authors.forename: Annie
authors.initials: A
authors.lastname: Umbricht
authors.forename: Carlo
authors.initials: C
authors.lastname: Contoreggi
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Fudala
authors.forename: Rolley E
authors.initials: RE
authors.lastname: Johnson
authors.forename: David A
authors.initials: DA
authors.lastname: Gorelick
mesh_terms: D000286:Administration, Sublingual; D000328:Adult; D002047:Buprenorphine / Q000008:administration & dosage / Q000627:therapeutic use*; D019970:Cocaine-Related Disorders / Q000523:psychology / Q000628:therapy* / Q000652:urine; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000523:psychology / Q000628:therapy* / Q000652:urine; D010349:Patient Compliance / Q000523:psychology*; D011613:Psychotherapy; D016896:Treatment Outcome
chemical_list: D009292:Narcotic Antagonists; D002047:Buprenorphine