title: Drug treatment outcomes among HIV-infected opioid-dependent patients receiving buprenorphine/naloxone.
abstract: BACKGROUND
  Buprenorphine/naloxone allows the integration of opioid dependence and HIV treatment.
  
  
  METHODS
  We conducted a prospective study in HIV-infected opioid-dependent patients to investigate the impact of buprenorphine/naloxone treatment on drug use. Self-report and chart review assessments were conducted every 3 months (quarters 1-4) for 1 year. Outcomes were buprenorphine/naloxone treatment retention, drug use, and addiction treatment processes.
  
  
  RESULTS
  Among 303 patients enrolled between July 2005 and December 2007, retention in buprenorphine/naloxone treatment was 74%, 67%, 59%, and 49% during Quarters 1, 2, 3, and 4, respectively. Past 30-day illicit opioid use decreased from 84% of patients at baseline to 42% in retained patients over the year. Patients were 52% less likely to use illicit opioids for each quarter in treatment (Odds ratio = 0.66; 95% CI: 0.61 to 0.72). Buprenorphine/naloxone doses and office visits approximated guidelines published by the United States Department of Health and Human Services. Urine toxicology monitoring was less frequent than recommended.
  
  
  CONCLUSIONS
  Buprenorphine/naloxone provided in HIV treatment settings can decrease opioid use. Strategies are needed to improve retention and address ongoing drug use in this treatment population.
authors.affiliation: Departments of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520-8093, USA. david.fiellin@yale.edu
authors.forename: David A
authors.initials: DA
authors.lastname: Fiellin
authors.forename: Linda
authors.initials: L
authors.lastname: Weiss
authors.forename: Michael
authors.initials: M
authors.lastname: Botsko
authors.forename: James E
authors.initials: JE
authors.lastname: Egan
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Altice
authors.forename: Lauri B
authors.initials: LB
authors.lastname: Bazerman
authors.forename: Amina
authors.initials: A
authors.lastname: Chaudhry
authors.forename: Chinazo O
authors.initials: CO
authors.lastname: Cunningham
authors.forename: Marc N
authors.initials: MN
authors.lastname: Gourevitch
authors.forename: Paula J
authors.initials: PJ
authors.lastname: Lum
authors.forename: Lynn E
authors.initials: LE
authors.lastname: Sullivan
authors.forename: Richard S
authors.initials: RS
authors.lastname: Schottenfeld
authors.forename: Patrick G
authors.initials: PG
authors.lastname: O'Connor
mesh_terms: D002047:Buprenorphine / Q000008:administration & dosage / Q000627:therapeutic use*; D000069479:Buprenorphine, Naloxone Drug Combination; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D009270:Naloxone / Q000008:administration & dosage / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D016017:Odds Ratio; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000150:complications* / Q000188:drug therapy*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000069479:Buprenorphine, Naloxone Drug Combination; D009292:Narcotic Antagonists; D009270:Naloxone; D002047:Buprenorphine