Improved quality of life, clinical, and psychosocial outcomes among heroin-dependent patients on ambulatory buprenorphine maintenance.
OBJECTIVE
A prospective longitudinal design was employed to examine the effects of buprenorphine maintenance on quality of life (QOL), clinical, and psychosocial characteristics of heroin-dependent patients.


METHODS
Between 2003 and 2005 data were collected on 259 patients attending the outpatient centers for treatment of drug addictions across Israel, of which 157 were reevaluated 16 weeks later and 105 reevaluated 32 weeks later using the Clinical Global Impression, Distress Scale for Adverse Symptoms, Quality of Life Enjoyment and Satisfaction Questionnaire, General Health Questionnaire, General Self-Efficacy Scale, and the Multidimensional Scale of Perceived Social Support. Univariate and multivariate analyses were conducted to examine the association between the parameters and the cross-sectional and longitudinal predictions of the QOL outcomes.


RESULTS
The groups did not differ in baseline values and their post-treatment ratings revealed significant improvement on virtually all the scales. Perceived self-efficacy and social support from friends and significant others at baseline as well as their changes over time were the best predictors of the QOL in the short and long terms. The study's limitations are noted.


CONCLUSIONS
The beneficial effects on the QOL were associated with improvement in the psychosocial parameters and a reduction in buprenorphine-related side effects and psychological distress. This study could stimulate research to compare the QOL related to buprenorphine and methadone treatment and serve as a basis on which a controlled study should be performed.
Ponizovsky
Alexander M
AM
Mental Health Services, Ministry of Health, Jerusalem, Israel. alexander.ponizovsky@moh.health.gov.il
Margolis
Anatoly
A
Heled
Ludmila
L
Rosca
Paula
P
Radomislensky
Irena
I
Grinshpoon
Alexander
A
D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000523:psychology*; D002047:Buprenorphine / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006556:Heroin Dependence / Q000188:drug therapy* / Q000523:psychology*; D006801:Humans; D008297:Male; D009292:Narcotic Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D010349:Patient Compliance; D011446:Prospective Studies; D011788:Quality of Life; D020377:Self Efficacy; D012944:Social Support; D013315:Stress, Psychological; D016896:Treatment Outcome
D009292:Narcotic Antagonists; D002047:Buprenorphine