Predictors of long term opioid withdrawal outcome after short-term stabilization with buprenorphine.

Using data from National Drug Abuse Treatment Clinical Trials Network protocol CTN-0003, “Suboxone Taper: A Comparison of Taper Schedules,” this study examined predictors of opiate abstinence status 3 months after the end of buprenorphine/naloxone treatment for opioid-dependent participants. Participants (n=516, age > 15 years), received buprenorphine/naloxone treatment for 4 weeks and then were randomly assigned to undergo dose tapering over either 7 or 28 days. Bivariate analysis was performed to identify possible predictors of successful opiate abstinence outcome (p-value < 0.10). Logistic regression analysis with backward stepwise selection was then performed to produce final model containing independent predictors at p-value < 0.05. Bivariate analysis identified several possible predictors, including: opioid and drug urine tests result at the end of taper; employment status, family problems, and alcohol use domains of the Addiction Severity Index (ASI) score; and the Clinical Opiate Withdrawal Scale (COWS) at the end of stabilization. The final predictor list identified by logistic regression included: ASI domains for family and alcohol problems, COWS at the end of stabilization, and opiate urine test at the end of taper.

Conclusions: In this analysis, participants presenting with a negative urine test for opiates at the end of the taper period, more severe alcohol or family problems (contrary to previous studies), or fewer symptoms of opiate withdrawal at the end of stabilization were more likely to have successful opiate abstinence.

Related protocols: CTN-0003