title: Buprenorphine from detox and beyond: preliminary evaluation of a pilot program to increase heroin dependent individuals' engagement in a full continuum of care.
abstract: Absence of successful transition to post-detoxification treatment leads to high rates of relapse among detoxified heroin users. The present study evaluated a pilot buprenorphine treatment program (BTP). Heroin dependent individuals were inducted onto buprenorphine/naloxone in detox, maintained while transitioning through an intensive inpatient program (IIP), and gradually tapered off medication over 5 months of outpatient (OP) treatment. Compared to programmatic indicators of treatment engagement in the year prior to BTP implementation, referrals from detox to IIP, entry into and completion of IIP and subsequent OP, and days in OP treatment increased substantially. BTP completers, compared to non-completers, viewed abstinence as more difficult and as requiring more assistance to achieve, were less likely to be current cocaine and alcohol users or to have relapsed during the course of treatment. Although preliminary and in need of replication, initial adjunctive use of buprenorphine in an abstinence-based continuum of care may improve post-detoxification treatment entry, engagement, and completion.
authors.affiliation: Alcohol and Drug Abuse Institute, University of Washington, Seattle, WA 98105, USA. ddonovan@u.washington.edu
authors.forename: Dennis M
authors.initials: DM
authors.lastname: Donovan
authors.forename: Patricia C
authors.initials: PC
authors.lastname: Knox
authors.forename: Jenny A F
authors.initials: JA
authors.lastname: Skytta
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Blayney
authors.forename: Jessica
authors.initials: J
authors.lastname: DiCenzo
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000534:rehabilitation; D000553:Ambulatory Care; D002047:Buprenorphine / Q000627:therapeutic use*; D019970:Cocaine-Related Disorders / Q000150:complications / Q000534:rehabilitation; D003627:Data Interpretation, Statistical; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006282:Health Personnel; D006556:Heroin Dependence / Q000188:drug therapy / Q000534:rehabilitation*; D006801:Humans; D007182:Income; D007902:Length of Stay; D008297:Male; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D010349:Patient Compliance; D018579:Patient Selection; D010865:Pilot Projects; D012008:Recurrence; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D009292:Narcotic Antagonists; D002047:Buprenorphine