title: Opioid addicted buprenorphine injectors: drug use during and after 12-weeks of buprenorphine-naloxone or methadone in the Republic of Georgia.
abstract: OBJECTIVE
  The aim of this study is to assess the prevalence of non-opioid drug use among opioid-addicted, buprenorphine injecting individuals in Georgia, during and after a 12-week course of buprenorphine-naloxone (Suboxone®) or methadone.
  
  
  METHODS
  Randomized controlled trial with daily observed Suboxone® or methadone and weekly counseling, urine tests and timeline followback (TLFB) in weeks 0-12 and 20, and the Addiction Severity Index (ASI) at weeks 0, 4, 8, 12, 20.
  
  
  RESULTS
  Of the 80 patients (40/group, 4 women), 68 (85%) completed the 12-weeks of study treatment and 66 (82.5%) completed the 20-week follow-up. At baseline, injecting more than one drug in the last 30 days was reported by 68.4% of patients in the methadone and 72.5% in the Suboxone® groups. Drug use was markedly reduced in both treatment conditions but there were significant differences in the prevalence of specific drugs with more opioid (1.5 vs. 0.2%; p=0.03), less amphetamine (0.2 vs. 2.8%; p<0.001) and less marijuana (1.7 vs. 10.2%; p<0.001) positive urine tests in the methadone vs. Suboxone® groups. At the 20-week follow-up, TLFB results on the 34 that continued methadone or the 3 on Suboxone® showed less opioid (5.6 vs. 27.6%; p<0.001), illicit buprenorphine (2.7 vs. 13.8%; p=0.005), benzodiazepine (13.5 vs. 34.5%; p<0.001), and marijuana (2.8 vs. 20.7%; p<0.001) use than the 29 who did not continue opioid substitution therapy.
  
  
  CONCLUSIONS
  Despite small but significant differences in opioid and other drug use, both treatments were highly effective in reducing opioid and non-opioid drug use.
authors.affiliation: Centre for Mental Health and Prevention of Addiction, 21a Kavtaradze str., Tbilisi, GA 0186, USA. Electronic address: gpirali@mail.ru.
authors.forename: Gvantsa
authors.initials: G
authors.lastname: Piralishvili
authors.affiliation: Addiction Research Center, Alternative Georgia, 14a Nutsubidze Street, Office 2,Tbilisi, GA 0177, USA. Electronic address: dato@altgeorgia.ge.
authors.forename: David
authors.initials: D
authors.lastname: Otiashvili
authors.affiliation: Medical Centre Uranti, Nutsubidze 5 Plateau, Build 2a, Tbilisi, GA 0183, USA. Electronic address: zuras@uranti.ge.
authors.forename: Zura
authors.initials: Z
authors.lastname: Sikharulidze
authors.affiliation: Health research Union, Nutsubidze 8, Tbilisi, GA 0177, USA. Electronic address: georgekamkamidze@gmail.com.
authors.forename: George
authors.initials: G
authors.lastname: Kamkamidze
authors.affiliation: Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania and Treatment Research Institute, 600 Public Ledger Bldg; 150 South Independence Mall (W) Philadelphia, PA 19106, USA. Electronic address: SPoole@tresearch.org.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Poole
authors.affiliation: Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania and Treatment Research Institute, 600 Public Ledger Bldg; 150 South Independence Mall (W) Philadelphia, PA 19106, USA. Electronic address: woody@tresearch.org.
authors.forename: George E
authors.initials: GE
authors.lastname: Woody
mesh_terms: D000328:Adult; D002047:Buprenorphine / Q000627:therapeutic use*; D000069479:Buprenorphine, Naloxone Drug Combination; D003376:Counseling; D055030:Drug Users / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D005846:Georgia (Republic); D006801:Humans; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009270:Naloxone / Q000627:therapeutic use*; D009294:Narcotics / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment / Q000523:psychology*; D009293:Opioid-Related Disorders / Q000523:psychology* / Q000534:rehabilitation; D015819:Substance Abuse, Intravenous / Q000523:psychology* / Q000534:rehabilitation; D016896:Treatment Outcome
chemical_list: D000069479:Buprenorphine, Naloxone Drug Combination; D009294:Narcotics; D009270:Naloxone; D002047:Buprenorphine; D008691:Methadone
keywords: Buprenorphine/naloxone; Methadone; Non-opioid drug use; Opioid substitution therapy