The association between cocaine use and treatment outcomes in patients receiving office-based buprenorphine/naloxone for the treatment of opioid dependence.
Cocaine use in patients receiving methadone is associated with worse treatment outcomes. The association between cocaine use and office-based buprenorphine/naloxone treatment outcomes is not known. We evaluated the association between baseline and in-treatment cocaine use, treatment retention, and urine toxicology results in 162 patients enrolled in a 24-week trial of primary care office-based buprenorphine/naloxone maintenance. Patients with baseline cocaine metabolite-negative urine toxicology tests compared with those with cocaine metabolite-positive tests had more mean weeks of treatment retention (18.3 vs. 15.8, p = .04), a greater percentage completed 24 weeks of treatment (50% vs. 33%, p = .04) and had a greater percentage of opioid-negative urines (47% vs. 34%, p = .02). Patients with in-treatment cocaine metabolite-negative urine toxicology tests compared with cocaine metabolite-positive patients had more mean weeks of treatment retention (19.0 vs. 16.5, p = .003), a greater percentage completed 24 weeks of treatment (60% vs. 30%, p < .001), and had a greater percentage of opioid-negative urines (51% vs. 35%, p = .001). We conclude that both baseline and in-treatment cocaine use is associated with worse treatment outcomes in patients receiving office-based buprenorphine/naloxone and may benefit from targeted interventions.
Sullivan
Lynn E
LE
Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut 06520-8093, USA. lynn.sullivan@yale.edu
Moore
Brent A
BA
O'Connor
Patrick G
PG
Barry
Declan T
DT
Chawarski
Marek C
MC
Schottenfeld
Richard S
RS
Fiellin
David A
DA
D000328:Adult; D002047:Buprenorphine / Q000008:administration & dosage*; D003042:Cocaine / Q000009:adverse effects* / Q000652:urine; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D013287:Illicit Drugs / Q000652:urine; D008297:Male; D055118:Medication Adherence; D009270:Naloxone / Q000008:administration & dosage*; D009292:Narcotic Antagonists / Q000008:administration & dosage*; D009819:Office Visits; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000652:urine; D016896:Treatment Outcome
D013287:Illicit Drugs; D009292:Narcotic Antagonists; D009270:Naloxone; D002047:Buprenorphine; D003042:Cocaine