Journal
JOURNAL OF SUBSTANCE ABUSE TREATMENT
Volume 39, Issue 1, Pages 51-57Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.jsat.2010.04.001
Keywords
Opioid dependence; Buprenorphine; Buprenorphine induction
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Funding
- NIAID NIH HHS [AI-51519, P30 AI051519] Funding Source: Medline
- NIDA NIH HHS [R25 DA023021, 5R25DA023021] Funding Source: Medline
- PHS HHS [6H97HA00247] Funding Source: Medline
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Despite data supporting its efficacy, barriers to implementation of buprenorphine for office-based treatment are present. Complications can occur during buprenorphine inductions, yet few published studies have examined this phase of treatment. To examine factors associated with complications during buprenorphine induction, we conducted a retrospective chart review of the first 107 patients receiving buprenorphine treatment in an urban community health center. The primary outcome, defined as complicated induction (precipitated or protracted withdrawal), was observed in 18 (16.8%) patients. Complicated inductions were associated with poorer treatment retention (than routine inductions) and decreased over time. Factors independently associated with complicated inductions included recent use of prescribed methadone, recent benzodiazepine use, no prior experience with buprenorphine, and a low initial dose of buprenorphine/naloxone. Findings from this study and further investigation of patient characteristics and treatment characteristics associated with complicated inductions can help guide buprenorphine treatment strategies. (C) 2010 Elsevier Inc. All rights reserved.
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