Prior buprenorphine experience is associated with office-based buprenorphine treatment outcomes

Chinazo O. Cunningham, Robert J. Roose, Joanna L. Starrels, Angela Giovanniello, Nancy L. Sohler

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objectives: As buprenorphine treatment and illicit buprenorphine use increase, many patients seeking buprenorphine treatment will have had prior experience with buprenorphine. Little evidence is available to guide optimal treatment strategies for patients with prior buprenorphine experience. We examined whether prior buprenorphine experience was associated with treatment retention and opioid use. We also explored whether type of prior buprenorphine use (prescribed or illicit use) was associated with these treatment outcomes. Methods: We analyzed interview and medical record data from a longitudinal cohort study of 87 individuals who initiated office-based buprenorphine treatment. We examined associations between prior buprenorphine experience and 6-month treatment retention using logistic regression models, and prior buprenorphine experience and any self-reported opioid use at 1, 3, and 6 months using nonlinear mixed models. Results: Most (57.4%) participants reported prior buprenorphine experience; of these, 40% used prescribed buprenorphine and 60% illicit buprenorphine only. Compared with buprenorphine-näive participants, those with prior buprenorphine experience had better treatment retention (adjusted odds ratio [AOR] = 2.65, 95% CI = 1.05-6.70). Similar associations that did not reach significance were found when exploring prescribed and illicit buprenorphine use. There was no difference in opioid use when comparing participants with prior buprenorphine experience with those who were buprenorphine-naive (AOR = 1.33, 95% CI = 0.38-4.65). Although not significant, qualitatively different results were found when exploring opioid use by type of prior buprenorphine use (prescribed buprenorphine vs buprenorphine-naïve, AOR = 2.20, 95% CI = 0.58-8.26; illicit buprenorphine vs buprenorphine- näive, AOR = 0.47, 95% CI = 0.07-3.46). Conclusions: Prior buprenorphine experience was common and associated with better retention. Understanding how prior buprenorphine experience affects treatment outcomes has important clinical and public health implications.

Original languageEnglish (US)
Pages (from-to)287-293
Number of pages7
JournalJournal of Addiction Medicine
Volume7
Issue number4
DOIs
StatePublished - Jul 2013

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Buprenorphine
Opioid Analgesics
Odds Ratio
Therapeutics

Keywords

  • Buprenorphine
  • Office-based treatment
  • Opioid
  • Opioid dependence

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)

Cite this

Prior buprenorphine experience is associated with office-based buprenorphine treatment outcomes. / Cunningham, Chinazo O.; Roose, Robert J.; Starrels, Joanna L.; Giovanniello, Angela; Sohler, Nancy L.

In: Journal of Addiction Medicine, Vol. 7, No. 4, 07.2013, p. 287-293.

Research output: Contribution to journalArticle

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abstract = "Objectives: As buprenorphine treatment and illicit buprenorphine use increase, many patients seeking buprenorphine treatment will have had prior experience with buprenorphine. Little evidence is available to guide optimal treatment strategies for patients with prior buprenorphine experience. We examined whether prior buprenorphine experience was associated with treatment retention and opioid use. We also explored whether type of prior buprenorphine use (prescribed or illicit use) was associated with these treatment outcomes. Methods: We analyzed interview and medical record data from a longitudinal cohort study of 87 individuals who initiated office-based buprenorphine treatment. We examined associations between prior buprenorphine experience and 6-month treatment retention using logistic regression models, and prior buprenorphine experience and any self-reported opioid use at 1, 3, and 6 months using nonlinear mixed models. Results: Most (57.4{\%}) participants reported prior buprenorphine experience; of these, 40{\%} used prescribed buprenorphine and 60{\%} illicit buprenorphine only. Compared with buprenorphine-n{\"a}ive participants, those with prior buprenorphine experience had better treatment retention (adjusted odds ratio [AOR] = 2.65, 95{\%} CI = 1.05-6.70). Similar associations that did not reach significance were found when exploring prescribed and illicit buprenorphine use. There was no difference in opioid use when comparing participants with prior buprenorphine experience with those who were buprenorphine-naive (AOR = 1.33, 95{\%} CI = 0.38-4.65). Although not significant, qualitatively different results were found when exploring opioid use by type of prior buprenorphine use (prescribed buprenorphine vs buprenorphine-na{\"i}ve, AOR = 2.20, 95{\%} CI = 0.58-8.26; illicit buprenorphine vs buprenorphine- n{\"a}ive, AOR = 0.47, 95{\%} CI = 0.07-3.46). Conclusions: Prior buprenorphine experience was common and associated with better retention. Understanding how prior buprenorphine experience affects treatment outcomes has important clinical and public health implications.",
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AU - Giovanniello, Angela

AU - Sohler, Nancy L.

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N2 - Objectives: As buprenorphine treatment and illicit buprenorphine use increase, many patients seeking buprenorphine treatment will have had prior experience with buprenorphine. Little evidence is available to guide optimal treatment strategies for patients with prior buprenorphine experience. We examined whether prior buprenorphine experience was associated with treatment retention and opioid use. We also explored whether type of prior buprenorphine use (prescribed or illicit use) was associated with these treatment outcomes. Methods: We analyzed interview and medical record data from a longitudinal cohort study of 87 individuals who initiated office-based buprenorphine treatment. We examined associations between prior buprenorphine experience and 6-month treatment retention using logistic regression models, and prior buprenorphine experience and any self-reported opioid use at 1, 3, and 6 months using nonlinear mixed models. Results: Most (57.4%) participants reported prior buprenorphine experience; of these, 40% used prescribed buprenorphine and 60% illicit buprenorphine only. Compared with buprenorphine-näive participants, those with prior buprenorphine experience had better treatment retention (adjusted odds ratio [AOR] = 2.65, 95% CI = 1.05-6.70). Similar associations that did not reach significance were found when exploring prescribed and illicit buprenorphine use. There was no difference in opioid use when comparing participants with prior buprenorphine experience with those who were buprenorphine-naive (AOR = 1.33, 95% CI = 0.38-4.65). Although not significant, qualitatively different results were found when exploring opioid use by type of prior buprenorphine use (prescribed buprenorphine vs buprenorphine-naïve, AOR = 2.20, 95% CI = 0.58-8.26; illicit buprenorphine vs buprenorphine- näive, AOR = 0.47, 95% CI = 0.07-3.46). Conclusions: Prior buprenorphine experience was common and associated with better retention. Understanding how prior buprenorphine experience affects treatment outcomes has important clinical and public health implications.

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