Search   |  Advanced

Research Summary

Abstinence Rates with Office-based Buprenorphine Treatment Differ by Retention and Insurance Status

As office-based treatment of opioid dependence with buprenorphine becomes more widespread, an increasing number of reports describe practices and outcomes in real-world settings. This report describes a highly structured office-based program that included a 1–2 day inpatient induction, 5 weeks of 3-hour counseling sessions 4 times per week, then weekly counseling sessions for an additional 12 weeks. Participants attended subsequent monthly follow-up visits and were required to attend thrice weekly 12-step meetings. Full adherence was required to remain in the program. Among the 110 of 176 (63%) consecutively admitted patients available for follow-up at a minimum of 18 months,

  • 85 patients (77%) reported continuous buprenorphine treatment.
  • retained patients were more likely to report abstinence (p=0.01) and to be employed (p=0.03) than nonretained patients.
  • retained patients with insurance were more likely to report abstinence than those without insurance (97% versus 86%, respectively) (p=0.04).

Comments:

The high retention rate in this structured office-based buprenorphine treatment program may reflect the selection of a highly motivated patient population. One might conservatively estimate that patients not available for follow-up had dropped out of treatment, resulting in a retention rate of 48% (similar to previous reports). The association between insurance status and abstinence is unsurprising given that treatment costs surely prevent full realization of efficacy. It further suggests that coverage for ongoing treatment of substance use disorders might improve long-term outcomes. Hillary Kunins, MD, MPH, MS

Reference:

Parran TV, Adelman CA, Merkin B, et al. Long-term outcomes of office-based buprenorphine/ naloxone maintenance therapy. Drug Alcohol Depend. 2009;106(1):56–60.

logos