Effectiveness of drug tests in outpatients starting opioid substitution therapy

J Subst Abuse Treat. May-Jun 2013;44(5):515-21. doi: 10.1016/j.jsat.2012.11.006. Epub 2013 Jan 20.

Abstract

We aimed to assess the effectiveness of drug tests for treatment retention in outpatients starting opioid substitution therapy. A retrospective cohort was created from the data of the French health insurance system database for the Midi-Pyrenees region. Patients starting opioid substitution treatment (OST) were included and followed for 18 to 30 months. Two groups of patients were defined: the drug test group (at least one drug test reimbursement) and a control group (no drug test reimbursement). The cohort included 1507 patients. During follow-up, 39 subjects (2.6%) had at least one drug test reimbursement. Mean treatment retention was 207 days in the control group and 411 days in the drug test group (p < 0.001). With a multivariate Cox model, drug tests were associated with treatment retention: hazard ratio 0.55 (95% CI: 0.38-0.80). Use of a drug test in follow-up of opioid substitution treatment, although rarely prescribed, significantly improved treatment retention.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Ambulatory Care
  • Cohort Studies
  • Databases, Factual
  • Female
  • Follow-Up Studies
  • France
  • Humans
  • Insurance, Health, Reimbursement
  • Male
  • Multivariate Analysis
  • Opiate Substitution Treatment / methods*
  • Opioid-Related Disorders / rehabilitation*
  • Outpatients
  • Proportional Hazards Models
  • Retrospective Studies
  • Substance Abuse Detection / methods*
  • Time Factors
  • Young Adult