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Inpatient Initiation of Buprenorphine Maintenance vs. Detoxification: Can Retention of Opioid‐Dependent Patients in Outpatient Counseling Be Improved?
Author(s) -
Caldiero Ryan M.,
Parran Theodore V.,
Adelman Christopher L.,
Piche Betty
Publication year - 2006
Publication title -
the american journal on addictions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.997
H-Index - 76
eISSN - 1521-0391
pISSN - 1055-0496
DOI - 10.1080/10550490500418989
Subject(s) - medicine , buprenorphine , detoxification (alternative medicine) , tramadol , abstinence , heroin , (+) naloxone , opioid , addiction , maintenance therapy , emergency medicine , referral , outpatient clinic , anesthesia , psychiatry , analgesic , drug , nursing , chemotherapy , alternative medicine , receptor , pathology
Buprenorphine‐naloxone is an office‐based opioid agonist released in 2003 in the United States for the maintenance of heroin‐ and other opioid‐dependent patients. Concern has been raised that the medication will distract or otherwise inhibit patients from participating in a holistic recovery program or abstinence‐based counseling. Using a retrospective chart review, the first thirty opioid‐dependent patients induced on buprenorphine maintenance therapy in an inpatient detoxification unit were compared to thirty age‐ and gender‐matched patients who underwent detoxification (with a tramadol taper) and referral to intensive outpatient treatment. The clinical outcomes were a comparison of completion rates for an intensive outpatient program (IOP) and retention in treatment after twelve weeks of aftercare therapy. Patients induced on buprenorphine maintenance over three days had similar relief of withdrawal symptoms to patients detoxified from opioids over five days with tramadol. Patients maintained on buprenorphine had a markedly increased initiation of IOP and remained in outpatient treatment longer than patients who were detoxified (8.5 wks vs. 0.4 wks, p<0.001). This study indicates that induction and maintenance on buprenorphine may be more effective than detoxification for engaging and retaining patients in abstinence‐based comprehensive outpatient addiction treatment.