Retention and attendance with supervised buprenorphine treatment: a case-note review.
Since 2001, the Langton Centre has used supervised administration of buprenorphine in treating heroin dependence, without distinguishing between detoxification and maintenance; most people commencing treatment may remain on buprenorphine indefinitely. The aim of this study was to describe retention in treatment, reasons for leaving, re-entry and pattern of attendance, and compare retention in practice with results from research trials, using a file review of sequential presentations for buprenorphine treatment. Retention in treatment was 37% at 6 months, the same as in Australian research trials of buprenorphine maintenance (37%); most people dropped-out without consultation or dose tapering. Repeated episodes of treatment constituted 45% of all episodes; missed scheduled doses were common. Participation in buprenorphine treatment often involves repeated, short episodes and erratic attendance. Measures to improve retention in treatment could improve treatment efficacy.
Bell
James
J
The Langton Centre, Surry Hills, New South Wales, Australia. bellj@sesahs.nsw.gov.au
Burrell
Tracy
T
D000293:Adolescent; D000328:Adult; D002047:Buprenorphine / Q000008:administration & dosage*; D004282:Documentation; D004334:Drug Administration Schedule; D005260:Female; D006556:Heroin Dependence / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009292:Narcotic Antagonists / Q000008:administration & dosage*; D009517:New South Wales; D010349:Patient Compliance / Q000523:psychology*; D010352:Patient Dropouts / Q000523:psychology*; D012008:Recurrence; D019233:Retreatment; D012189:Retrospective Studies; D016896:Treatment Outcome
D009292:Narcotic Antagonists; D002047:Buprenorphine