A case series of buprenorphine/naloxone treatment in a primary care practice

Subst Abus. 2011 Oct;32(4):262-5. doi: 10.1080/08897077.2011.599256.


Physicians' adoption of buprenorphine/naloxone treatment is hindered by concerns over feasibility, cost, and lack of comfort treating patients with addiction. We examined the use of buprenorphine/naloxone in a community practice by two generalist physicians without addiction training, employing a retrospective chart review. From 2006-2010, 228 patients with opiate abuse/dependence were treated with buprenorphine/naloxone using a home-induction protocol. Multiple co-morbidities including diabetes (23% of patients), hypertension (36%), Hepatitis C (43%), and depression (74%) were concurrently managed. In this diverse sample, 1/228 experienced precipitated withdrawal during induction. Of the convenience subsample analyzed (n = 28), 82% (+/-10%) had negative urine drug tests for opioids; 92% (+/-11%) were negative for cocaine; 88% (+/-12%) were positive for buprenorphine. This case series demonstrated feasibility and safety of a low-cost buprenorphine/naloxone home induction protocol employed by generalists. Concurrent treatment of multiple comorbidities conforms with the patient-centered medical home ideal. Randomized trials of this promising approach are needed.

MeSH terms

  • Buprenorphine / therapeutic use*
  • Buprenorphine, Naloxone Drug Combination
  • Comorbidity
  • Drug Combinations
  • Humans
  • Naloxone / therapeutic use*
  • Opioid-Related Disorders / drug therapy*
  • Opioid-Related Disorders / epidemiology*
  • Primary Health Care / statistics & numerical data*
  • Retrospective Studies
  • Self Administration / statistics & numerical data*


  • Buprenorphine, Naloxone Drug Combination
  • Drug Combinations
  • Naloxone
  • Buprenorphine