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A Community-Based, Two-Phase Randomized Controlled Trial of Buprenorphine With and Without Individual Drug Counseling for the Treatment of Opioid Analgesic Addiction.

Poster presented at the American Public Health Association (APHA) Annual Meeting, Denver, CO, November 6-10, 2010.

Scott E. Provost, MSW, MM (McLean Hospital, NEC Node), Jennifer Sharpe Potter, PhD, MPH (McLean Hospital, NEC Node), Roger D. Weiss, MD (McLean Hospital, NEC Node), Petra Jacobs, MD (CTN Clinical Coordinating Center, NIDA), Walter Ling, MD (Integrated Substance Abuse Programs, University of California, PR Node).

Prescription opioid addiction is a growing public health problem, yet up to know there has been relatively little systemaci evidence on the characteristics of this patient population, how they differ from heroin dependent patients, and what the optimal treatment approach is. Treating prescription opioid dependence raises three questions: To what extent does adjunctive specialty drug counseling improve outcomes when added to buprenorphine plus medical management; how long should buprenorphine treatment continue; and does co-occurring chronic pain affect treatment outcome? This NIDA-funded National Drug Abuse Treatment Clinical Trials Network protocol (CTN-0030) sought to address this gap by conducting a large, multi-site trial examining duration of buprenorphine/naloxone (bup/nx) treatment, and the role of counseling treatment in addition to medical management for patients, with and without chronic pain dependent on prescription opioids. Results found that tapering from opioids, whether initially or after a period of substantial improvement, led to nearly universal relapse. Additionally, standard medication management produced outcomes equal to standard medication management plus opioid drug counseling. Lastly, patients with chronic pain did as well as those without chronic pain, many having significant improvement in their pain.

Conclusions: These findings suggest that physicians in a general medical setting can successfully treat many patients dependent upon prescription opioids, with or without chronic pain, using bup/nx with relatively brief medical management visits. However, the relative contributions of the bup/nx, medical monitoring, and the counseling component of standard medical management remain unclear. (Poster, PDF, English, 2010)

Keywords: Buprenorphine | Buprenorphine/Naloxone | CTN primary outcomes | Heroin | Opioid dependence | Opioid detoxification | Pharmacological therapy | Prescription-type opiates | Suboxone | Taper schedules | American Public Health Association (APHA) annual meeting, 2010

Document No: 777.

Submitted by CTN Dissemination Librarians, 11/21/2011.

AUTHORS SEARCH LINK
Jacobs, Petra search mail
Ling, Walter search mail
Potter, Jennifer Sharpe search mail
Provost, Scott E. search mail
Weiss, Roger D. search mail
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Supported by a grant from the National Institute on Drug Abuse to the University of Washington Alcohol and Drug Abuse Institute.
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