Treating Opioid Addiction with Buprenorphine-naloxone in Community-based Primary Care Settings

Overview

Journal Ann Fam Med

Specialty Public Health

Date 2007 Mar 29

PMID 17389539

Citations 54

Authors

Ira L Mintzer

Mark Eisenberg

Maria Terra

Casey MacVane

David U Himmelstein

Steffie Woolhandler

Affiliations

Soon will be listed here.

Abstract

Purpose: Office-based treatment of opioid addiction with a combination of buprenorphine and naloxone was approved in 2002. Efficacy of this treatment in non-research 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 buprenorphine-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 non-research 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.

Citing Articles

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Stakeholder perspectives on a telemedicine referral and coordination model to expand medication treatment for opioid use disorder in rural primary care clinics.

Ober A, Dopp A, Clingan S, Curtis M, Lin C, Calhoun S J Subst Use Addict Treat. 2023; 156:209194.

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Nudging primary care providers to expand the opioid use disorder workforce.

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Associations of retention on buprenorphine for opioid use disorder with patient characteristics and models of care in the primary care setting.

Bailey S, Lucas J, Angier H, Cantone R, Fleishman J, Garvey B J Subst Abuse Treat. 2021; 131:108548.

PMID: 34244013 PMC: 8664960. DOI: 10.1016/j.jsat.2021.108548.

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