Retention in methadone and buprenorphine treatment among African Americans

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

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)287-292
Number of pages6
JournalJournal of Substance Abuse Treatment
Volume45
Issue number3
DOIs
StatePublished - Sep 2013
Externally publishedYes

Keywords

  • African Americans
  • Buprenorphine
  • Dropout
  • Methadone
  • Retention

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health

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