Interim buprenorphine treatment in opiate dependence: A pilot effectiveness study

Area of Science:

• Addiction Medicine
• Pharmacology

Background:

• Interim methadone treatment has been studied for opioid maintenance initiation.
• Buprenorphine, with a favorable safety profile, has been less explored for interim treatment.
• This study assesses interim buprenorphine feasibility for opioid use disorder (OUD) treatment initiation.

Purpose of the Study:

• To evaluate the feasibility of interim buprenorphine treatment for initiating OUD patients into full-scale treatment.
• To identify baseline predictors of successful transfer to long-term opioid maintenance treatment.

Main Methods:

• A pilot study implemented interim buprenorphine-naloxone treatment for patients on a waiting list for opioid maintenance treatment.
• Treatment involved supervised daily doses in a medication-only setting.
• Successful transfer required a drug-free urine sample.

Main Results:

• 57% of 44 patients successfully transferred to full-scale treatment after an average of 44 days.
• Successful transfer was associated with lower baseline Alcohol Use Disorders Identification Test (AUDIT) scores.
• Lower AUDIT scores were the only significant predictor of successful treatment entry in logistic regression.

Conclusions:

• Supervised interim buprenorphine-naloxone is a feasible method to improve OUD treatment initiation in high-threshold settings.
• Polydrug use, particularly higher alcohol consumption, may complicate interim treatment success.