title: Characteristics of U.S. substance abuse treatment facilities adopting buprenorphine in its initial stage of availability.
abstract: This study examined the adoption of buprenorphine for the treatment of opiate dependence among U.S. substance abuse treatment facilities and their characteristics at the time of the initial availability of the medication. Data come from a 2003 national survey of all substance abuse treatment facilities in the U.S. Out of our sample of 13,060 facilities, 5.5% of facilities reported they offered buprenorphine. Not unexpectedly, the prevalence was higher in certified opioid treatment programs (11.3%) compared to other facilities (4.6%). For opioid treatment programs, offering Naltrexone (OR=8.34, 95% CI=5.53, 12.58) and offering medically supervised withdrawal (OR=2.76, 95% CI=1.38, 5.52) were independent and robust predictors of offering buprenorphine. These same variables were independent predictors for the non-opioid treatment programs as well (Naltrexone, OR=14.32, 95% CI=7.85, 26.10; and medically supervised withdrawal services, OR=4.42, 95% CI=3.01, 6.49). Our results suggest that the adoption of buprenorphine soon after the Food and Drug Administration approved its use for treatment of opioid dependence and the shipping of the medication commenced was associated with facilities already offering pharmacotherapies such as Naltrexone and medically assisted withdrawal. These findings provide baseline data to track the adoption of buprenorphine by substance abuse treatment programs in future years.
authors.affiliation: Wayne State University, 2761 E. Jefferson Avenue, Detroit, MI 48207, USA. akoch@med.wayne.edu
authors.forename: Alison L
authors.initials: AL
authors.lastname: Koch
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Arfken
authors.forename: Charles R
authors.initials: CR
authors.lastname: Schuster
mesh_terms: D002047:Buprenorphine / Q000009:adverse effects / Q000627:therapeutic use*; D003625:Data Collection; D017277:Drug Approval; D006801:Humans; D009271:Naltrexone / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000627:therapeutic use; D009294:Narcotics / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data*; D018581:Technology Transfer; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D009292:Narcotic Antagonists; D009294:Narcotics; D002047:Buprenorphine; D009271:Naltrexone