title: A comparison of characteristics and outcomes of opioid-dependent patients initiating office-based buprenorphine or methadone maintenance treatment.
abstract: BACKGROUND
  The purpose of this study was to compare demographic factors and 1-year treatment outcomes of patients treated with buprenorphine or methadone.
  
  
  METHODS
  The study included 252 subjects who received a prescription for buprenorphine in an academic internal medicine practice and 252 subjects who enrolled in a methadone maintenance program located on the same campus over the same time frame. Data were collected retrospectively. Patients were classified as "opioid-positive" or "opioid-negative" each month for a year based on urine drug testing and provider assessment. Successful treatment was defined as remaining in treatment after 1 year and achieving 6 or more opioid-negative months.
  
  
  RESULTS
  Buprenorphine patients were more likely to be male, have health insurance, be employed, abuse prescription opioids, and be human immunodeficiency virus (HIV) infected; they were less likely to abuse benzodiazepines. At 12 months, 140 (55.6%) of buprenorphine patients and 156 (61.9%) of methadone patients remained in treatment (P =.148). Patients on methadone had a higher mean number of opioid-negative months (6.96 vs. 5.43; P <.001) and mean number of months in treatment (9.38 vs. 8.59; P <.001). On multivariable analysis, methadone maintenance was significantly associated with successful treatment (adjusted odds ratio: 2.10; 95% confidence interval: 1.43-3.07).
  
  
  CONCLUSIONS
  Office-based buprenorphine and methadone maintenance programs serve very different populations. Both are effective, but patients on methadone had mildly better treatment outcomes.
authors.affiliation: a Department of Medicine , The Johns Hopkins University , Baltimore , Maryland , USA.
authors.forename: Michael I
authors.initials: MI
authors.lastname: Fingerhood
authors.forename: Van L
authors.initials: VL
authors.lastname: King
authors.forename: Robert K
authors.initials: RK
authors.lastname: Brooner
authors.forename: Darius A
authors.initials: DA
authors.lastname: Rastegar
mesh_terms: D000328:Adult; D002047:Buprenorphine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007388:Internal Medicine; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use; D009294:Narcotics / Q000627:therapeutic use; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013333:Student Health Services; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D009292:Narcotic Antagonists; D009294:Narcotics; D002047:Buprenorphine; D008691:Methadone
keywords: Buprenorphine, methadone, opioid-dependent, treatment