WASHINGTON – Patients with severe opioid use immediately prior to treatment may not adhere to buprenorphine in an office-based setting, said Michael Pantalon, Ph.D.
In an ongoing randomized clinical trial, 91 opioid-dependent patients took daily buprenorphine/naloxone maintenance doses in a primary care clinic. After 24 weeks, the investigators classified the patients as “high-stable” adherence (52), “fluctuating-deteriorating” adherence (23) and “poor-flat” adherence (16). Baseline evaluations included motivation for treatment, severity of psychiatric and addictive symptoms, and urinalysis.
Overall, the 52 “high-stable” patients had spent significantly less money on drugs prior to treatment, and reported significantly fewer days of heroin use prior to treatment compared with those in both the “fluctuating-deteriorating” and “poor-flat” groups, Dr. Pantalon and his colleagues at Yale University, New Haven, reported in a poster presented at the annual conference of the Association for Medical Education and Research in Substance Abuse.
The “high-stable” patients also were significantly less likely to name heroin as their major problem, compared with oxycodone (OxyContin) or other opiates, and they were significantly less likely to test positive for opioids before starting buprenorphine treatment. These data suggest that office-based treatment alone may not be sufficient for severe addicts, the investigators noted.
The conference was sponsored by Brown Medical School.