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Abstinence-Orientated Buprenorphine Replacement Therapy for Young Adults in Out-Patient Counselling

NCJ Number
Drug and Alcohol Review Volume: 25 Issue: 2 Dated: March 2006 Pages: 123-130
Hege Kornor; Helge Waal; Robert L. Ali
Date Published
March 2006
8 pages
This study assessed treatment retention, compliance, and completion of a 9-month buprenorphine replacement therapy program for young adults.
Naturalistic observations are provided of key outcomes during short-term buprenorphine replacement therapy in a selected study sample. Participants showed improvements in several areas as long as they were on a maintenance dose of buprenorphine, but detoxification was less straightforward than expected and elicited a psychological vulnerability that warranted intense patient supervision. It is not recommended to discontinue any opioid replacement therapy against the patient’s will. Many countries offer time-limited opioid agonist replacement programs in addition to counseling as an early intervention for opioid dependence. Posttreatment outcomes of maintenance programs have been generally poor and limited. Buprenorphine, a partial opioid agonist, is an alternative to the full agonist methadone for the purpose of maintenance treatment. Buprenorphine is seen as potentially well-suited for short-term treatment with eventual goals of detoxification and subsequent abstinence from prescribed and illicit opioids alike. In this study, outpatients were selected as participants in a 9-month buprenorphine program because of the limited effect counseling alone has on heroin use and because it is widely believed among professionals that younger, less severely dependent patients have a better prognosis than those with longer and more complex histories of substance use. The study attempted to examine changes in drug use and other relevant patient variables across the three phases of treatment induction, stabilization and detoxification, assess completion, retention, and compliance, and identify possible predictors of program completion. 1 figure, 2 tables, and 41 references