title: Buprenorphine for opiate dependence: clinic based therapy in Israel.
abstract: BACKGROUND
  Opioid dependency is characterized by repeated use of an opioid drug despite physical dependence, behavioral impairments and social dysfunction. Therapeutic approaches for the treatment of opioid dependence are total abstinence and opioid agonist maintenance treatment (OAMT). Opiate agonist maintenance therapy is administered using opioid replacement pharmacological agents, i.e., methadone or buprenorphine. Methadone acts as a full opiate agonist while buprenorphine acts as a partial agonist. Strict supervision is necessary when dispensing methadone, because overdose can be fatal. Buprenorphine associates with opioid receptors slowly but with high affinity, and dissociation from the receptor site is (pseudo) irreversible. It is safer than opioid full agonists such as methadone.
  
  
  METHODS
  We probed the therapeutic efficacy of buprenorphine using a retrospective evaluation of numerical data in the first private buprenorphine clinic in Israel. Data was collected for all patients attending the clinic in December 2012. Our indicator for treatment success is retention in the program.
  
  
  RESULTS
  During the years 2005-2012, 1,399 individuals approached the clinic; 1,224 (87.5%) of them attended the clinic at least twice; treatment adherence in this group was 66.5 % at the end of one year.
  
  
  CONCLUSIONS
  The success rates of patients who are treated with buprenorphine and are able to eventually return to their families and re-enter the workforce is encouraging. Thus, the community based minimal intervention treatment model using buprenorphine for the treatment of opiate dependence is a viable treatment option in the war against opiate abuse.
authors.affiliation: Hebetim Clinics, Tel Aviv, Israel Lev Hasharon Mental Health Center, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Limor
authors.initials: L
authors.lastname: Goren
authors.affiliation: Shalvata Mental Health Center, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ziv
authors.initials: Z
authors.lastname: Carmel
authors.affiliation: Hebetim Clinics, Tel Aviv, Israel Beer Yakov Mental Health Center, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Sergio
authors.initials: S
authors.lastname: Marchevsky
mesh_terms: D000328:Adult; D002047:Buprenorphine / Q000008:administration & dosage / Q000494:pharmacology*; D006801:Humans; D007557:Israel; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000494:pharmacology*; D058850:Opiate Substitution Treatment / Q000379:methods*; D009293:Opioid-Related Disorders / Q000188:drug therapy*
chemical_list: D009292:Narcotic Antagonists; D002047:Buprenorphine