Leaving buprenorphine treatment: patients' reasons for cessation of care

J Subst Abuse Treat. 2014 Mar;46(3):356-61. doi: 10.1016/j.jsat.2013.10.004. Epub 2013 Oct 14.

Abstract

Many opioid-dependent patients leave treatment prematurely. This study is a planned secondary analysis from a randomized trial of counseling for African Americans (N=297) entering buprenorphine treatment at one of two outpatient programs. This study examines: (1) whether patients' initial treatment duration intentions prospectively predict retention; and (2) patients' reasons for leaving treatment. Participants were queried about their treatment duration intentions at treatment entry, and their reasons for leaving treatment at 6-month follow-up. At baseline, 28.0% reported wanting to stay in buprenorphine treatment less than 6 months, while 42.1% actually left buprenorphine treatment within 6 months. However, participants intending short-term buprenorphine at the outset were not at elevated risk of early treatment discontinuation (OR=1.15; p=.65). Participants attributed treatment cessation predominantly to conflicts with staff, involuntary discharge, and perceived inflexibility of the program. Future research should examine patient-centered models of buprenorphine treatment that could improve retention.

Keywords: Buprenorphine; Dropout; Opioid dependence; Patient intentions; Retention.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • African Americans
  • Analgesics, Opioid / therapeutic use*
  • Buprenorphine / therapeutic use*
  • Counseling
  • Female
  • Humans
  • Male
  • Middle Aged
  • Opioid-Related Disorders / drug therapy*
  • Opioid-Related Disorders / psychology
  • Patient Dropouts*

Substances

  • Analgesics, Opioid
  • Buprenorphine