title: Treating opioid addiction with buprenorphine-naloxone in community-based primary care settings.
abstract: OBJECTIVE
  Office-based treatment of opioid addiction with a combination of buprenorphine and naloxone was approved in 2002. Efficacy of this treatment in non-research clinical settings has not been studied. We examined the efficacy and practicality of buprenorphine-naloxone treatment in primary care settings.
  
  
  METHODS
  We studied a cohort of 99 consecutive patients enrolled in buprenorphine-naloxone treatment for opioid dependence at 2 urban primary care practices: a hospital-based primary care clinic, and a primary care practice in a free-standing neighborhood health center. The primary outcome measure was sobriety at 6 months as judged by the treating physician based on periodic urine drug tests, as well as frequent physical examinations and questioning of the patients about substance use.
  
  
  RESULTS
  Fifty-four percent of patients were sober at 6 months. There was no significant correlation between sobriety and site of care, drug of choice, neighborhood poverty level, or dose of buprenorphine-naloxone. Sobriety was correlated with private insurance status, older age, length of treatment, and attending self-help meetings.
  
  
  CONCLUSIONS
  Opioid-addicted patients can be safely and effectively treated in non-research primary care settings with limited on-site resources. Our findings suggest that greater numbers of patients should have access to buprenorphine-naloxone treatment in nonspecialized settings.
authors: Harvard Medical School/Cambridge Health Alliance, Cambridge, MA 02139, USA. imintzer@challiance.org
authors: Ira L
authors: IL
authors: Mintzer
authors: Mark
authors: M
authors: Eisenberg
authors: Maria
authors: M
authors: Terra
authors: Casey
authors: C
authors: MacVane
authors: David U
authors: DU
authors: Himmelstein
authors: Steffie
authors: S
authors: Woolhandler
mesh_terms: D000328:Adult; D002047:Buprenorphine / Q000627:therapeutic use*; D003153:Community Health Services / Q000379:methods*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D015999:Multivariate Analysis; D009270:Naloxone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D010044:Outpatient Clinics, Hospital; D011320:Primary Health Care / Q000379:methods*; D012657:Self-Help Groups; D016896:Treatment Outcome
chemical_list: D004338:Drug Combinations; D009292:Narcotic Antagonists; D009270:Naloxone; D002047:Buprenorphine