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Randomized Controlled Trial
. 2013 Sep;45(3):287-92.
doi: 10.1016/j.jsat.2013.02.008. Epub 2013 Apr 5.

Retention in methadone and buprenorphine treatment among African Americans

Jan Gryczynski  1 , Shannon Gwin Mitchell, Jerome H Jaffe, Sharon M Kelly, C Patrick Myers, Kevin E O'Grady, Yngvild K Olsen, Robert P Schwartz
Affiliations
Randomized Controlled Trial

Retention in methadone and buprenorphine treatment among African Americans

Jan Gryczynski et al. J Subst Abuse Treat. 2013 Sep.

Abstract

Methadone has been the most commonly used pharmacotherapy for the treatment of opioid dependence in U.S. public sector treatment, but availability of buprenorphine as an alternative medication continues to increase. Drawing data from two community-based clinical trials that were conducted nearly contemporaneously, this study examined retention in methadone versus buprenorphine treatment over 6 months among urban African Americans receiving treatment in one of four publicly-funded programs (N=478; 178 methadone; 300 buprenorphine). Adjusting for confounds related to medication selection, survival analysis revealed that buprenorphine patients are at substantially higher risk of dropout compared to methadone patients (HR=2.43; p<.001). Buprenorphine's retention disadvantage appears to be concentrated in the earlier phases of treatment (approximately the first 50 days), after which risk of subsequent dropout becomes similar for the two medications. These findings confirm a retention disparity between methadone and buprenorphine in this population, and suggest potential avenues for future research to enhance retention in buprenorphine treatment.

Keywords: African Americans; Buprenorphine; Dropout; Methadone; Retention.

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Figures

Figure 1
Figure 1
Kaplan-Meier survival curves for methadone and buprenorphine.
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References

    1. Agency for Healthcare Research and Quality. AHRQ Healthcare Innovations Exchange. Rockville, MD: U.S. Department of Health and Human Services; 2011. Dec, Community partnerships and provider training increase service capacity and access to long-term treatment for individuals with heroin addiction. Retrieved May 14, 2012, from http://www.innovations.ahrq.gov/content.aspx?id=1827.
    1. Barnett PG, Rodgers JH, Bloch DA. A meta-analysis comparing buprenorphine to methadone for treatment of opiate dependence. Addiction. 2001;96:683–690. - PubMed
    1. Barnett PG. Comparison of costs and utilization among buprenorphine and methadone patients. Addiction. 2009;104:982–992. - PubMed
    1. Bell J, Trinh L, Butler B, Randall D, Rubin G. Comparing retention in treatment and mortality in people after initial entry to methadone and buprenorphine treatment. Addiction. 2009;104:1193–1200. - PubMed
    1. Burns L, Randall D, Hall WD, Law M, Butler T, Bell J, Degenhardt L. Opioid agonist pharmacotherapy in New South Wales from 1985 to 2006: Patient characteristics and patterns and predictors of treatment retention. Addiction. 2009;104:1363–1372. - PubMed

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