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The Association between Cocaine Use and Treatment Outcomes in Patients Receiving Office‐Based Buprenorphine/Naloxone for the Treatment of Opioid Dependence
Author(s) -
Sullivan Lynn E.,
Moore Brent A.,
O'Connor Patrick G.,
Barry Declan T.,
Chawarski Marek C.,
Schottenfeld Richard S.,
Fiellin David A.
Publication year - 2009
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 - 10.1111/j.1521-0391.2009.00003.x
Subject(s) - buprenorphine , medicine , methadone , (+) naloxone , urine , metabolite , opioid , methadone maintenance , anesthesia , opioid use disorder , receptor
Cocaine use in patients receiving methadone is associated with worse treatment outcomes. The association between cocaine use and office‐based buprenorphine/naloxone treatment outcomes is not known. We evaluated the association between baseline and in‐treatment cocaine use, treatment retention, and urine toxicology results in 162 patients enrolled in a 24‐week trial of primary care office‐based buprenorphine/naloxone maintenance. Patients with baseline cocaine metabolite‐negative urine toxicology tests compared with those with cocaine metabolite‐positive tests had more mean weeks of treatment retention (18.3 vs. 15.8, p = .04), a greater percentage completed 24 weeks of treatment (50% vs. 33%, p = .04) and had a greater percentage of opioid‐negative urines (47% vs. 34%, p = .02). Patients with in‐treatment cocaine metabolite‐negative urine toxicology tests compared with cocaine metabolite‐positive patients had more mean weeks of treatment retention (19.0 vs. 16.5, p = .003), a greater percentage completed 24 weeks of treatment (60% vs. 30%, p < .001), and had a greater percentage of opioid‐negative urines (51% vs. 35%, p = .001). We conclude that both baseline and in‐treatment cocaine use is associated with worse treatment outcomes in patients receiving office‐based buprenorphine/naloxone and may benefit from targeted interventions. (Am J Addict 2009;19:53–58)