Using buprenorphine to facilitate entry into residential therapeutic community rehabilitation

J Subst Abuse Treat. 2007 Mar;32(2):167-75. doi: 10.1016/j.jsat.2006.03.018. Epub 2006 Nov 21.

Abstract

For opioid-dependent patients, the need for detoxification has been a barrier to entry into long-term residential treatment. This report describes a retrospective observational cohort study with the first 38 opioid-dependent patients entering First Step, a 14-day buprenorphine-naloxone (Suboxone) detoxification regimen integrated into a long-term residential therapeutic community (TC) program. Eighty-nine percent (34 of 38) of First Step patients completed a 14-day buprenorphine taper protocol, 50% (19 of 38) completed an initial 3- to 4-week stay, and 39% (15 of 38) completed at least 3 months of residential treatment at the TC. Retention did not differ significantly in a demographically matched concurrently admitted control group without impending opioid withdrawal, in which 65% (24 of 37) completed an initial 3- to 4-week stay (p = .20) and 57% (21 of 37) completed at least 3 months of treatment (p = .14). Withdrawal symptoms were mild, and there were no instances of precipitated withdrawal. The findings suggest the potential for buprenorphine to serve as a bridge, improving the viability of long-term residential treatment for managing opioid dependence.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Alcoholism / psychology
  • Alcoholism / rehabilitation
  • Buprenorphine / therapeutic use*
  • Clinical Trials as Topic
  • Cocaine-Related Disorders / psychology
  • Cocaine-Related Disorders / rehabilitation
  • Female
  • Heroin Dependence / psychology
  • Heroin Dependence / rehabilitation
  • Humans
  • Long-Term Care
  • Male
  • Middle Aged
  • Naloxone / therapeutic use
  • Narcotic Antagonists / therapeutic use
  • Narcotics / therapeutic use*
  • Neurologic Examination / drug effects
  • New York City
  • Opioid-Related Disorders / psychology
  • Opioid-Related Disorders / rehabilitation*
  • Patient Dropouts / psychology
  • Residential Treatment*
  • Retrospective Studies
  • Substance Withdrawal Syndrome / psychology
  • Substance Withdrawal Syndrome / rehabilitation
  • Therapeutic Community*

Substances

  • Narcotic Antagonists
  • Narcotics
  • Naloxone
  • Buprenorphine