Factors associated with complicated buprenorphine inductions

J Subst Abuse Treat. 2010 Jul;39(1):51-7. doi: 10.1016/j.jsat.2010.04.001.


Despite data supporting its efficacy, barriers to implementation of buprenorphine for office-based treatment are present. Complications can occur during buprenorphine inductions, yet few published studies have examined this phase of treatment. To examine factors associated with complications during buprenorphine induction, we conducted a retrospective chart review of the first 107 patients receiving buprenorphine treatment in an urban community health center. The primary outcome, defined as complicated induction (precipitated or protracted withdrawal), was observed in 18 (16.8%) patients. Complicated inductions were associated with poorer treatment retention (than routine inductions) and decreased over time. Factors independently associated with complicated inductions included recent use of prescribed methadone, recent benzodiazepine use, no prior experience with buprenorphine, and a low initial dose of buprenorphine/naloxone. Findings from this study and further investigation of patient characteristics and treatment characteristics associated with complicated inductions can help guide buprenorphine treatment strategies.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Benzodiazepines / adverse effects
  • Benzodiazepines / therapeutic use
  • Buprenorphine / administration & dosage*
  • Buprenorphine / adverse effects
  • Buprenorphine / therapeutic use
  • Community Health Centers
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Male
  • Methadone / adverse effects
  • Methadone / therapeutic use
  • Middle Aged
  • Naloxone / administration & dosage
  • Naloxone / therapeutic use
  • Narcotic Antagonists / administration & dosage*
  • Narcotic Antagonists / adverse effects
  • Narcotic Antagonists / therapeutic use
  • Opioid-Related Disorders / rehabilitation*
  • Retrospective Studies
  • Substance Withdrawal Syndrome / etiology*
  • Time Factors
  • Treatment Outcome
  • Urban Health Services


  • Narcotic Antagonists
  • Benzodiazepines
  • Naloxone
  • Buprenorphine
  • Methadone