Treatment completion on an inpatient detoxification unit: Impact of a change to sublingual buprenorphine-naloxone

Janet Jacapraro, Darius A Rastegar

Research output: Contribution to journalArticle

Abstract

Purpose: Buprenorphine is commonly used for opioid detoxification. The goal of this study was to determine whether a change from the intramuscular (IM) buprenorphine to the sublingual (SL) formulation of buprenorphine-naloxone was associated with improved treatment completion rates on an inpatient detoxification unit. Methods: This study was conducted at the Johns Hopkins Bayview Medical Center (JHBMC) Chemical Dependence Unit (CDU), a 26-bed, 3-day inpatient detoxification unit providing detoxification from opioids, alcohol, and sedatives. The opioid detoxification protocol was changed from IM buprenorphine (0.3 mg bid for 3 days) to SL buprenorphine-naloxone (8, 8, and 6 mg on sequential days, plus 2 mg on the morning of discharge). For the 3 months prior to and after the change in protocol, data were collected retrospectively on demographics, type of dependence being treated, and type of discharge. Findings: A total of 1,168 patients were admitted to the JHBMC CDU during the period studied. In the 3 months prior to the change in buprenorphine protocol, 353 of 483 patients admitted for treatment of opioid dependence (73.1%) completed treatment, compared with 407 of 473 patients admitted after the change (86.0%); this difference was highly significant (p <.0001). Among 212 patients who did not receive treatment for opioid dependence over the same period, the rates of treatment completion did not change significantly (89.8% before vs. 83.0% after; p = .208). Conclusions: A change from IM buprenorphine to SL buprenorphine-naloxone for opioid detoxification was associated with a significant improvement in completion rates at this inpatient treatment program.

Original languageEnglish (US)
Pages (from-to)401-404
Number of pages4
JournalJournal of Substance Abuse Treatment
Volume33
Issue number4
DOIs
StatePublished - Dec 2007

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Buprenorphine
Opioid Analgesics
Inpatients
Therapeutics
Hypnotics and Sedatives
Naloxone Drug Combination Buprenorphine
Alcohols
Demography

Keywords

  • Buprenorphine
  • Detoxification
  • Opioid
  • Outcome
  • Substance abuse

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Neuroscience(all)

Cite this

Treatment completion on an inpatient detoxification unit : Impact of a change to sublingual buprenorphine-naloxone. / Jacapraro, Janet; Rastegar, Darius A.

In: Journal of Substance Abuse Treatment, Vol. 33, No. 4, 12.2007, p. 401-404.

Research output: Contribution to journalArticle

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abstract = "Purpose: Buprenorphine is commonly used for opioid detoxification. The goal of this study was to determine whether a change from the intramuscular (IM) buprenorphine to the sublingual (SL) formulation of buprenorphine-naloxone was associated with improved treatment completion rates on an inpatient detoxification unit. Methods: This study was conducted at the Johns Hopkins Bayview Medical Center (JHBMC) Chemical Dependence Unit (CDU), a 26-bed, 3-day inpatient detoxification unit providing detoxification from opioids, alcohol, and sedatives. The opioid detoxification protocol was changed from IM buprenorphine (0.3 mg bid for 3 days) to SL buprenorphine-naloxone (8, 8, and 6 mg on sequential days, plus 2 mg on the morning of discharge). For the 3 months prior to and after the change in protocol, data were collected retrospectively on demographics, type of dependence being treated, and type of discharge. Findings: A total of 1,168 patients were admitted to the JHBMC CDU during the period studied. In the 3 months prior to the change in buprenorphine protocol, 353 of 483 patients admitted for treatment of opioid dependence (73.1{\%}) completed treatment, compared with 407 of 473 patients admitted after the change (86.0{\%}); this difference was highly significant (p <.0001). Among 212 patients who did not receive treatment for opioid dependence over the same period, the rates of treatment completion did not change significantly (89.8{\%} before vs. 83.0{\%} after; p = .208). Conclusions: A change from IM buprenorphine to SL buprenorphine-naloxone for opioid detoxification was associated with a significant improvement in completion rates at this inpatient treatment program.",
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