Long-term outcomes of office-based buprenorphine/naloxone maintenance therapy.
BACKGROUND
Buprenorphine/naloxone was approved by the FDA for office-based opioid maintenance therapy (OMT), with little long-term follow-up data from actual office-based practice. 18-Month outcome data on the office-based use of buprenorphine/naloxone (bup/nx) and the impact of socioeconomic status and other patient characteristics on the duration and clinical effects of bup/nx are reported.


METHODS
This retrospective chart review and cross-sectional telephone interview provide treatment retention of opioid-dependent patients receiving bup/nx-OMT in an office-based setting. 176 opioid-dependent patients from two different socioeconomic groups (high and low SES) were begun on bup/nx, started intensive outpatient treatment, and followed-up after a minimum of 18 months (18-42 months) by telephone interview to assess treatment outcome.


RESULTS
110 subjects (67%) completed the interview, 77% remained on bup/nx with no difference in retention between high and low SES groups. Those on bup/nx at follow-up were more likely to report abstinence, to be affiliated with 12-step recovery, to be employed and to have improved functional status.


CONCLUSIONS
Bup/nx-OMT is a viable treatment option and when coupled with a required abstinence oriented addiction counseling program is effective in promoting abstinence, self-help group attendance, occupational stability, and improved psychosocial outcomes in both low SES and high SES patient populations over an 18-42-month period.
Parran
T V
TV
Rosary Hall, St. Vincent Charity Hospital, Cleveland, OH 44115, United States. tvp@cwru.edu
Adelman
C A
CA
Merkin
B
B
Pagano
M E
ME
Defranco
R
R
Ionescu
R A
RA
Mace
A G
AG
D000328:Adult; D000368:Aged; D002047:Buprenorphine / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009270:Naloxone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D010349:Patient Compliance; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013375:Substance Withdrawal Syndrome / Q000517:prevention & control; D016896:Treatment Outcome; D055815:Young Adult
D009292:Narcotic Antagonists; D009270:Naloxone; D002047:Buprenorphine