Predictors of outcome after short-term stabilization with buprenorphine.

Using buprenorphine as a medication to treat opioid dependence is becoming more prevalent as illicit opiate use increases. Identifying the characteristics of opiate dependent individuals best suited to benefit from buprenorphine would improve guidelines for its administration. This ancillary investigation of data from National Drug Abuse Treatment Clinical Trials Network (CTN) protocol CTN-0003 (“Suboxone (Buprenorphine/Naloxone) Taper : A Comparison of Taper Schedules”) evaluates baseline and treatment participation variables for predicting positive response to short-term stabilization with buprenorphine. Data include demographic, drug use, and other variables collected from participants undergoing stabilization over a 4-week period before being tapered off buprenorphine in a short-term detoxification process as part of CTN-0003. Outcome variables include opioid use and retention. Several characteristics were associated with opioid use at the end of the stabilization period, including age, criminal history, and previous opioid use. In particular, criminal activity and opioid use in the last 30 days were significantly associated with shorter treatment stays.

Conclusions: The findings from this study have important clinical applications for treatment providers, specifically providing information for those who offer buprenorphine treatment to opiate-dependent patients. Treatment providers and private practice clinicians may find it useful to know that positive outcomes may be likely when using buprenorphine for short-term treatment in some patients. For example, these findings show that those with more severe withdrawal symptoms at baseline do not experience higher levels of drop out or continued opiate use. Conversely, these findings have identified those for whom this short-term treatment with buprenorphine may not be successful such as those who use opioids more often, have a previous treatment experience, and have a criminal justice history. These findings support previous study results demonstrating that those with more severe drug use and less social stability are less likely to have positive treatment outcomes.

Related protocols: CTN-0003