Primary Care Office-Based Buprenorphine Treatment

Comparison of Heroin and Prescription Opioid Dependent Patients

This study compared success of buprenorphine/naloxone treatment regimes in heroin users versus prescription opioid users or those who used a combination of heroin and prescription opioids. Demographic and clinical characteristics, as well as treatment outcomes, were compared among 166 patients in primary care office settings. Success of treatment was gauged by consecutive weeks of abstinence from opioids in each patient, as measured by absence of opioids in urine samples.

Results indicated that patients using only prescription opioids showed better treatment response than those using heroin. Fifty-nine percent of prescription opioid-only patients completed treatment, compared with 30 percent of heroin-using patients; the former also stayed in treatment longer (21 weeks versus 14.2 weeks) and had more negative urine samples (56.3% versus 39.8%). Patients who used both types of drugs had outcomes that fell into the middle of these values. Data gathered suggests that prescription opioid users are seeking treatment earlier in their course of drug addiction than are heroin users. Prescription opioid users also are more likely to be White and less likely to have antibodies to Hepatitis C.

Limitations of this study include small sample size of the prescription opioid-only group (n=29), the fact that only one treatment site was studied, and that the trial was not set up to determine a comprehensive measure of patients' lifetime drug use before entering treatment. Further research is necessary to evaluate other parameters, for example whether findings are similar in other treatment programs such as methadone maintenance programs.

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