Hospitalized opioid-dependent patients: Exploring predictors of buprenorphine treatment entry and retention after discharge.
OBJECTIVE
Few studies have explored predictors of entry into and retention in buprenorphine treatment following linkage from an acute medical hospitalization.


METHODS
This secondary analysis of a completed clinical trial focuses on medically hospitalized, opioid-dependent patients (n = 72) who were randomized to an intervention including buprenorphine induction and dose stabilization during hospitalization followed by post-discharge transition to office-based buprenorphine treatment (OBOT). Predictors included demographics, days hospitalized, prior buprenorphine/methadone treatment, PTSD symptoms, social support, and readiness for drug use cessation. Outcome variables were treatment entry and retention (number of days in OBOT).


RESULTS
Previous buprenorphine treatment, more days hospitalized, and higher PTSD symptoms predicted OBOT entry. Prior treatment, older age, and non-minority status were associated with a higher mean number of days in OBOT.


CONCLUSIONS
OBOT may appeal to patients who have tried buprenorphine in other settings. Linking hospitalized patients to OBOT may improve utilization of addiction treatment.


CONCLUSIONS
Prior substance treatment, longer hospital stay, and mental health should be examined in future linkage studies. (Am J Addict 2017;26:667-672).
Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts.
Christina S
http://orcid.org/0000-0002-2278-9888
CS
Lee
Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston, Massachusetts.|Boston University School of Medicine, Boston, Massachusetts.
Jane M
JM
Liebschutz
Department of Behavioral Medicine, Butler Hospital, Providence, Rhode Island.
Bradley J
BJ
Anderson
Department of Behavioral Medicine, Butler Hospital, Providence, Rhode Island.|Boston University School of Public Health, Boston, Massachusetts.
Michael D
MD
Stein
D000328:Adult; D002047:Buprenorphine / Q000008:administration & dosage / Q000009:adverse effects; D003266:Continuity of Patient Care / Q000458:organization & administration*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000009:adverse effects; D058850:Opiate Substitution Treatment / Q000379:methods / Q000523:psychology; D009293:Opioid-Related Disorders / Q000188:drug therapy / Q000523:psychology; D010351:Patient Discharge; D010352:Patient Dropouts; D012307:Risk Factors; D016896:Treatment Outcome
D009292:Narcotic Antagonists; D002047:Buprenorphine; D008691:Methadone