A naturalistic comparison of the effectiveness of methadone and two sublingual formulations of buprenorphine on maintenance treatment outcomes: Findings from a retrospective multisite study
| Autor: | Nadiya Polukhina, Amy L. Copeland, Steven L. Proctor, Philip L. Herschman, Albert M. Kopak |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Methadone maintenance Adolescent Chemistry Pharmaceutical Administration Sublingual Urinalysis Young Adult Age Distribution Internal medicine medicine Humans Pharmacology (medical) Retrospective Studies Pharmacology Analysis of Variance business.industry Medical record Retrospective cohort study Middle Aged Opioid-Related Disorders medicine.disease United States Confidence interval Buprenorphine Analgesics Opioid Substance abuse Psychiatry and Mental health Treatment Outcome Opioid Female business Methadone Clinical psychology medicine.drug |
| Zdroj: | Experimental and Clinical Psychopharmacology. 22:424-433 |
| ISSN: | 1936-2293 1064-1297 |
| DOI: | 10.1037/a0037550 |
| Popis: | Objective This study sought to compare the effectiveness of the 3 most commonly prescribed maintenance medications in the United States indicated for the treatment of opioid dependence in reducing illicit drug use and retaining patients in treatment. Method Data were abstracted from electronic medical records for 3,233 patients admitted to 34 maintenance treatment facilities located throughout the United States during the period of July 1, 2012, through July 1, 2013. Patients were grouped into 1 of 3 medication categories based on their selection at intake (methadone [n = 2,738; M dosage = 64.64 mg/d, SD = 25.58], Suboxone [n = 102; M dosage = 9.75 mg/d, SD = 4.04], or Subutex [n = 393; M dosage = 12.21 mg/d, SD = 5.31]) and were studied through retrospective chart review for 6 months or until treatment discharge. Two measures of patient retention in treatment and urinalysis drug screen (UDS) findings for both opioids and various nonopioid substances comprised the study outcomes. Results The average length of stay (LOS) in terms of days in treatment for the methadone group (M = 169.86, SE = 5.02) was significantly longer than both the Subutex (M = 69.34, SE = 23.43) and Suboxone (M = 119.35, SE = 20.82) groups. The Suboxone group evinced a significantly longer average LOS relative to the Subutex group. After adjustment for relevant covariates, patients maintained on methadone were 3.73 times (95% confidence interval [CI]= 2.82-4.92) and 2.48 times (95% CI = 1.57-3.92) more likely to be retained in treatment at 6 months than patients prescribed Subutex and Suboxone, respectively. The 6-month prevalence rates of positive UDS findings for both opioids and nonopioid substances were similar across medication groups. Conclusions Comparable rates of illicit drug use at 6 months may be expected irrespective of maintenance medication, while increased retention may be expected for patients maintained on methadone relative to those maintained on Suboxone or Subutex. |
| Databáze: | OpenAIRE |
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