Treating opioid addiction with buprenorphine-naloxone in community-based primary care settings

Ann Fam Med. Mar-Apr 2007;5(2):146-50. doi: 10.1370/afm.665.

Abstract

Purpose: Office-based treatment of opioid addiction with a combination of buprenorphine and naloxone was approved in 2002. Efficacy of this treatment in non-research clinical settings has not been studied. We examined the efficacy and practicality of buprenorphine-naloxone treatment in primary care settings.

Methods: We studied a cohort of 99 consecutive patients enrolled in buprenorphine-naloxone treatment for opioid dependence at 2 urban primary care practices: a hospital-based primary care clinic, and a primary care practice in a free-standing neighborhood health center. The primary outcome measure was sobriety at 6 months as judged by the treating physician based on periodic urine drug tests, as well as frequent physical examinations and questioning of the patients about substance use.

Results: Fifty-four percent of patients were sober at 6 months. There was no significant correlation between sobriety and site of care, drug of choice, neighborhood poverty level, or dose of buprenorphine-naloxone. Sobriety was correlated with private insurance status, older age, length of treatment, and attending self-help meetings.

Conclusions: Opioid-addicted patients can be safely and effectively treated in non-research primary care settings with limited on-site resources. Our findings suggest that greater numbers of patients should have access to buprenorphine-naloxone treatment in nonspecialized settings.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Adult
  • Buprenorphine / therapeutic use*
  • Community Health Services / methods*
  • Drug Combinations
  • Female
  • Humans
  • Insurance, Health
  • Male
  • Massachusetts
  • Middle Aged
  • Multivariate Analysis
  • Naloxone / therapeutic use*
  • Narcotic Antagonists / therapeutic use*
  • Opioid-Related Disorders / drug therapy*
  • Outpatient Clinics, Hospital
  • Primary Health Care / methods*
  • Self-Help Groups
  • Treatment Outcome

Substances

  • Drug Combinations
  • Narcotic Antagonists
  • Naloxone
  • Buprenorphine