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Addiction Psychiatry 2018
Journal of Addiction Research & Therapy
ISSN: 2155-6105
Page 21
August 13-14, 2018
Madrid, Spain
8
th
International Conference on
Addiction Psychiatry
Statement of Problem:
Globally in 2010 15.5 million people
struggled with an opioid use disorder (OUD). OUD is a
chronic, relapsing condition leading to significant morbidity
and mortality. Since the advent of buprenorphine/naloxone
pharmacotherapy with its US FDA approval in 2002, its use
has expanded in the US and abroad. This form of medication-
assisted treatment (MAT) has been found to decrease
mortality and morbidity. Research on long term outcomes of
buprenorphine/naloxone treatment is limited by small numbers
and short duration of follow-up, leaving unanswered questions
about impact of comorbidities and dosing on retention rates
and patient outcomes.
Purpose:
The purpose of this study was to examine retention
rates in an office-based opioid treatment clinic at 18 months,
identifying opioid abstinence rates, and comparing dosing
among long term completers (remaining 18 months or longer)
versus non-completers, who exited <18 months.
Methodology:
A retrospective study was conducted on 182
patients enrolled in the outpatient MAT clinic from 2009-2014.
Completion rate was 48.9%.
Findings:
Findings indicated no gender differences in
completion. Significant age differences were evident (p=0.02)
with the mean age of completers = 31 vs. 34.7 years for non-
completers. The only psychiatric co-morbidity that predicted
reaching the 18 month target was suicidal ideation, odds ratio
= 2.35. Patients having suicidal ideation were significantly
(p=.045) more likely to remain in treatment for at least 18
months. Number of comorbid diagnoses did not predict
retention. Dose of buprenorphine at point of program exit for
non-completers was on average = 12.7 mg versus 17 mg for
completers (p=00000002.3). There were four non-completers
prescribed 24 mg of buprenorphine versus 23 completers
on 24 mg. Completers were more likely to be abstinent from
opioids compared to non-completers (p=.0002).
Result:
Results suggest that buprenorphine dose predicts
retention. Implications regarding US policies regarding
buprenorphine dosing warrant reconsideration.
Recent Publications
1. Degenhardt L, Ferrari A J, Calabria B, et al. (2013)
The global epidemiology and contribution of
cannabis use and dependence to the global burden of
disease: Results from the GBD 2010 study. PLoS One
DOI:10.1371/journal.pone.0076635.
2. Bell J, Trinh L, Butler B, Randall D and Rubin G (2009)
Comparing retention in treatment and mortality
in people after initial entry to methadone and
buprenorphine treatment. Addiction 104(7):1193-
1200.
3. Genberg B L, Gillespie M, Schuster C R, et al. (2013)
Prevalence and correlates of street-obtained
buprenorphine use among current and former injectors
in Baltimore, Maryland. Addict Behav. 38(12):2868-
2873.
4. Bascaran M T, Garcia Portilla M P, Bobes Bascaran M
T, Saiz P A and Bobes J (2014) Long term outcomes of
pharmacological treatments for opioid dependence:
does methadone still lead the pack? Br J Clin
Pharmacol. 77(2):272-284.
5. Fiellin D A, Schottenfeld R S, Cutter C J, Moore B A,
Barry D T and O’Connor P G (2014) Primary care–
based buprenorphine taper vs. maintenance therapy
for prescription opioid dependence: A randomized
clinical trial. JAMA Intern Med. 174(12):1947-1954.
A retrospective study of retention of opioid-dependent adults
in an outpatient buprenorphine/naloxone clinic
David W Hartman
and
Cheryl W Hartman
Carilion Clinic, USA
David W Hartman et al., J Addict Res Ther 2018, Volume 9
DOI: 10.4172/2155-6105-C2-039