title: Group medication management for buprenorphine/naloxone in opioid-dependent veterans.
abstract: OBJECTIVE
  Substance use disorders are a key concern among US veterans. Substance use disorder pharmacotherapies with support for effectiveness are limited. Buprenorphine/naloxone (Suboxone) is an effective opioid replacement treatment option for opioid use disorder when used as part of a comprehensive treatment program. In June 2011, the Veterans Affairs San Diego Healthcare System began using a group format to prescribe buprenorphine/naloxone. This study aimed at examining outcomes of retention rates and percentage opioid negative urine samples. Results were compared for veteran patients seen in group versus individual formats.
  
  
  METHODS
  This retrospective chart review included data from 32 patients who were prescribed buprenorphine/naloxone between a 3-year window (ie, January 1, 2010, and December 31, 2012).
  
  
  RESULTS
  Overall results were 46% retention in treatment after 1 year, and 94% of opioid urine samples were negative. More patients seen in group were retained in treatment at 1 year compared with those seen individually (69% vs 27%, respectively; P < 0.03).
  
  
  CONCLUSIONS
  This study found that veterans prescribed buprenorphine/naloxone in a group setting as part of a drug and alcohol treatment program were retained in treatment longer than veterans prescribed this medication individually. Because of inherent limitations in the study design, no causality can be determined; however, given the results found here, group medication management of buprenorphine/naloxone should be explored further.
authors.affiliation: From the Veterans Affairs San Diego Healthcare System (RB, CP, JL, SG, SR), San Diego, CA; University of California San Diego School of Pharmacy (RB, JL), San Diego; and Department of Psychiatry (CP, SG, SR), University of California San Diego School of Medicine.
authors.forename: Reisel
authors.initials: R
authors.lastname: Berger
authors.forename: Carmen
authors.initials: C
authors.lastname: Pulido
authors.forename: Jonathan
authors.initials: J
authors.lastname: Lacro
authors.forename: Stephen
authors.initials: S
authors.lastname: Groban
authors.forename: Shannon
authors.initials: S
authors.lastname: Robinson
mesh_terms: D002047:Buprenorphine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009270:Naloxone / Q000008:administration & dosage / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment / Q000379:methods*; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D011615:Psychotherapy, Group / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D014728:Veterans / Q000523:psychology
chemical_list: D009292:Narcotic Antagonists; D009270:Naloxone; D002047:Buprenorphine