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. 2015 Dec:51:136-42.
doi: 10.1016/j.addbeh.2015.07.030. Epub 2015 Jul 29.

Bridging waitlist delays with interim buprenorphine treatment: initial feasibility

Stacey C Sigmon  1 , Andrew C Meyer  2 , Bryce Hruska  2 , Taylor Ochalek  3 , Gail Rose  2 , Gary J Badger  4 , John R Brooklyn  2 , Sarah H Heil  5 , Stephen T Higgins  5 , Brent A Moore  6 , Robert P Schwartz  7
Affiliations

Bridging waitlist delays with interim buprenorphine treatment: initial feasibility

Stacey C Sigmon et al. Addict Behav. 2015 Dec.

Abstract

Despite the effectiveness of agonist maintenance for opioid dependence, individuals can remain on waitlists for months, during which they are at significant risk for morbidity and mortality. Interim dosing, consisting of daily medication without counseling, can reduce these risks. In this pilot study, we examined the initial feasibility of a novel technology-assisted interim buprenorphine treatment for waitlisted opioid-dependent adults. Following buprenorphine induction during Week 1, participants (n=10) visited the clinic at Weeks 2, 4, 6, 8, 10 and 12 to ingest their medication under staff observation, provide a urine specimen and receive their remaining doses via a computerized Med-O-Wheel Secure device. They also received daily monitoring via an Interactive Voice Response (IVR) platform, as well as random call-backs for urinalysis and medication adherence checks. The primary outcome was percent of participants negative for illicit opioids at each 2-week visit, with secondary outcomes of past-month drug use, adherence and acceptability. Participants achieved high levels of illicit opioid abstinence, with 90% abstinent at the Week 2 and 4 visits and 60% at Week 12. Significant reductions were observed in self-reported past-month illicit opioid use (p<.001), opioid withdrawal (p<.001), opioid craving (p<.001) and ASI Drug composite score (p=.008). Finally, adherence with buprenorphine administration (99%), daily IVR calls (97%) and random call-backs (82%) was high. Interim buprenorphine treatment shows promise for reducing patient and societal risks during delays to conventional treatment. A larger-scale, randomized clinical trial is underway to more rigorously examine the efficacy of this treatment approach.

Keywords: Buprenorphine; Interim treatment; Opioid abuse; Technology.

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Conflict of interest statement

Author Disclosures

Declarations: All authors declare that they have no conflicts of interest.

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References

    1. Adamson SJ, Sellman D. The pattern of intravenous drug use and associated criminal activity in patients on a methadone treatment waiting list. Drug Alcohol Rev. 1998;17:159–166. - PubMed
    1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: Author; 2013.
    1. Armitage P. Exclusions, losses to follow-up, and withdrawals in clinical trials. In: Shapiro SH, Lewis TA, editors. Clinical Trials: Issues and Approaches. New York, NY: Marcel Dekker, Inc; 1983. pp. 99–113.
    1. Barry DT, Irwin KS, Jones ES, Becker WC, Tetrault JM, Sullivan LE, et al. Integrating buprenorphine treatment into office-based practice: A qualitative study. J Gen Intern Med. 2008;24:218–225. - PMC - PubMed
    1. Becker WC, Fiellin DA. Provider satisfaction with office-based treatment of opioid dependence a systematic review. Subst Abuse. 2006;26:15–22. - PubMed

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