Cunningham Chinazo, Giovanniello Angela, Sacajiu Galit, Whitley Susan, Mund Pamela, Beil Robert, Sohler Nancy
Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY 10467, USA
Fam Med. 2008 Jul-Aug;40(7):500-6.
Despite new opportunities to expand buprenorphine treatment for opioid dependence, use of this treatment modality has been limited. Physicians may question their ability to successfully treat opioid-dependent patients with buprenorphine in a primary care setting. We describe a buprenorphine treatment program and treatment outcomes in an urban community health center.
We conducted retrospective chart reviews on the first 41 opioid-dependent patients treated with buprenorphine/naloxone. The primary outcome was 90-day retention in treatment.
Patients' mean age was 46 years, 70.7% were male, 58.8% Hispanic, 31.7% black, 57.5% unemployed, and 70.0% used heroin prior to treatment. Twenty-nine (70.7%) patients were retained in treatment at day 90. Compared to those not retained, patients retained in treatment were more likely to have used street methadone (0% versus 37.9%) and less likely to have used opioid analgesics (54.6% versus 20.7%) and alcohol (50.0% versus 13.8%) prior to treatment. Of the 25 patients with urine toxicology tests, 24% tested positive for opioids.
Buprenorphine treatment for opioid dependence in an urban community health center resulted in a 90-day retention rate of 70.7%. Type of substance use prior to treatment appeared to be associated with retention. These findings can help guide program development.
尽管有新的机会扩大丁丙诺啡治疗阿片类药物依赖的范围，但这种治疗方式的使用仍然有限。医生可能会质疑他们在初级保健环境中用丁丙诺啡成功治疗阿片类药物依赖患者的能力。我们描述了一个城市社区卫生中心的丁丙诺啡治疗项目及其治疗结果。
我们对首批41例接受丁丙诺啡/纳洛酮治疗的阿片类药物依赖患者进行了回顾性病历审查。主要结局是治疗90天的留存率。
患者的平均年龄为46岁，70.7%为男性，58.8%为西班牙裔，31.7%为黑人，57.5%失业，70.0%在治疗前使用过海洛因。29例（70.7%）患者在第90天仍在接受治疗。与未留存的患者相比，留存治疗的患者在治疗前更有可能使用过街头美沙酮（0%对37.9%），而使用阿片类镇痛药（54.6%对20.7%）和酒精（50.0%对13.8%）的可能性较小。在25例接受尿液毒理学检测的患者中，24%的阿片类药物检测呈阳性。
在城市社区卫生中心，丁丙诺啡治疗阿片类药物依赖的90天留存率为70.7%。治疗前的物质使用类型似乎与留存率有关。这些发现有助于指导项目的开展。
