title: Colocating buprenorphine with methadone maintenance and outpatient chemical dependency services.
abstract: Buprenorphine may be used to treat opioid dependence in office-based settings, but treatment models are needed to ensure access to psychosocial services needed by many patients. We describe a novel buprenorphine treatment program colocated with methadone maintenance and outpatient chemical dependency services. We conducted a retrospective chart review of the first 40 consecutive patients initiating buprenorphine treatment in this program to determine characteristics associated with treatment retention. Exclusion criteria were current alcohol or benzodiazepine dependence. Secondary drug users and patients who were psychiatrically or medically ill were included. At 6 months, 60% (n = 24) were retained, 13% (n = 5) tested positive for opiates, and 25% (n = 10) tested positive for secondary substances. Patients who were older (odds ratio [OR] per year of age = 1.1, confidence interval [CI] = 1.0-1.2) and those who were employed (OR = 9.8, CI = 1.8-53.1) were more likely to remain in treatment, but other variables were not associated with retention. Our experience demonstrates that buprenorphine can be successfully integrated into outpatient substance abuse treatment.
authors.affiliation: Division of Substance Abuse, Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10451, USA. swhitley@dosa.aecom.yu.edu
authors.forename: Susan D
authors.initials: SD
authors.lastname: Whitley
authors.forename: Hillary V
authors.initials: HV
authors.lastname: Kunins
authors.forename: Julia H
authors.initials: JH
authors.lastname: Arnsten
authors.forename: Marc N
authors.initials: MN
authors.lastname: Gourevitch
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D002047:Buprenorphine / Q000627:therapeutic use*; D003376:Counseling; D019033:Delivery of Health Care, Integrated; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008692:Methadyl Acetate / Q000627:therapeutic use; D008875:Middle Aged; D009270:Naloxone / Q000627:therapeutic use; D009294:Narcotics / Q000627:therapeutic use*; D009519:New York City; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team; D010352:Patient Dropouts; D012947:Social Work; D015813:Substance Abuse Detection
chemical_list: D009294:Narcotics; D009270:Naloxone; D002047:Buprenorphine; D008692:Methadyl Acetate; D008691:Methadone