Leaving buprenorphine treatment: patients' reasons for cessation of care.
Many opioid-dependent patients leave treatment prematurely. This study is a planned secondary analysis from a randomized trial of counseling for African Americans (N=297) entering buprenorphine treatment at one of two outpatient programs. This study examines: (1) whether patients' initial treatment duration intentions prospectively predict retention; and (2) patients' reasons for leaving treatment. Participants were queried about their treatment duration intentions at treatment entry, and their reasons for leaving treatment at 6-month follow-up. At baseline, 28.0% reported wanting to stay in buprenorphine treatment less than 6 months, while 42.1% actually left buprenorphine treatment within 6 months. However, participants intending short-term buprenorphine at the outset were not at elevated risk of early treatment discontinuation (OR=1.15; p=.65). Participants attributed treatment cessation predominantly to conflicts with staff, involuntary discharge, and perceived inflexibility of the program. Future research should examine patient-centered models of buprenorphine treatment that could improve retention.
Friends Research Institute, Inc., 1040 Park Avenue, Suite 103, Baltimore, MD 21201, USA. Electronic address: jgryczynski@friendsresearch.org.
Jan
J
Gryczynski
Friends Research Institute, Inc., 1040 Park Avenue, Suite 103, Baltimore, MD 21201, USA.
Shannon Gwin
SG
Mitchell
Friends Research Institute, Inc., 1040 Park Avenue, Suite 103, Baltimore, MD 21201, USA; University of Maryland School of Medicine, Department of Psychiatry, Baltimore, MD 21201, USA.
Jerome H
JH
Jaffe
University of Maryland, College Park, Department of Psychology, College Park, MD 20742, USA.
Kevin E
KE
O'Grady
Institutes for Behavior Resources, Inc., REACH Health Services, Baltimore, MD 21218, USA.
Yngvild K
YK
Olsen
Friends Research Institute, Inc., 1040 Park Avenue, Suite 103, Baltimore, MD 21201, USA.
Robert P
RP
Schwartz
D000328:Adult; D001741:Black or African American; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D002047:Buprenorphine / Q000627:therapeutic use*; D003376:Counseling; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000523:psychology; D010352:Patient Dropouts
D000701:Analgesics, Opioid; D002047:Buprenorphine
Buprenorphine; Dropout; Opioid dependence; Patient intentions; Retention