RT Journal Article
SR Electronic
T1 Treating Opioid Addiction With Buprenorphine-Naloxone in Community-Based Primary Care Settings
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 146
OP 150
DO 10.1370/afm.665
VO 5
IS 2
A1 Mintzer, Ira L.
A1 Eisenberg, Mark
A1 Terra, Maria
A1 MacVane, Casey
A1 Himmelstein, David U.
A1 Woolhandler, Steffie
YR 2007
UL http://www.annfammed.org/content/5/2/146.abstract
AB 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.