Adding Telephone Support to Office-Based Buprenorphine Treatment for Opioid Dependence Has Modest Effects

HereToHelp™ (HTH) is a telephonic support system for people with opioid dependence developed by Reckitt Benckiser, the manufacturer of Suboxone (buprenorphine/naloxone). For this study, 1426 patients new to buprenorphine treatment were recruited from 324 sites and randomized to standard care or HTH (up to 8 coaching calls providing support in 3 areas: education about opioid dependence and treatment; assistance resolving challenges within treatment; and encouragement to stay in treatment). Outcomes were assessed for those who completed the 12-month follow-up survey (n=939; 66%). The main outcome was adherence, defined as taking buprenorphine as prescribed for at least 80% of the previous 28 days.

• Adherence was not significantly different between the 2 groups (55%), but those in the HTH group who accepted at least 3 calls reported better adherence (64%).

• Subjects in the HTH group were less likely to report using opioids in the previous month (12.9% versus 17.8%).

• There was no significant difference in Addiction Severity Index composite scores between groups.

• Subjects in the HTH group were more likely to report attending a self-help group (34.2% versus 27.0%).

Comments:

The authors emphasize the outcomes of those who participated in the support system and conclude that the intervention is effective. However, in reality, this study is consistent with others that found buprenorphine to be an effective treatment for opioid dependence, with the addition of adjunctive counseling (beyond standard medical management) having modest additional effects, if any.

Darius A. Rastegar, MD

Reference:

Ruetsch C, Tkacz J, McPherson TL, et al. The effect of a telephonic patient support on treatment for opioid dependence: outcomes at one year follow-up. Addict Behav. 2012;37(5):686–689.