Abstract
PURPOSE Office-based treatment of opioid addiction with a combination of buprenorphine and naloxone was approved in 2002. Efficacy of this treatment in nonresearch 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 buprenor-phine-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 nonresearch 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.
- Opiate addiction
- narcotic addiction/drug therapy
- narcotic antagonists
- substance abuse
- primary health care
- primary care issues
- research, practice-based
- patient selection
- Received for publication June 19, 2006.
- Revision received October 10, 2006.
- Accepted for publication October 23, 2006.
- © 2007 Annals of Family Medicine, Inc.