Primary Care Research Institute, Family Medicine, University at Buffalo, 77 Goodell Street, Buffalo, NY 14203, USA.
Addict Behav. 2013 Nov;38(11):2724-8. doi: 10.1016/j.addbeh.2013.07.007. Epub 2013 Jul 25.
Opioid addiction is prevalent in the United States. Detoxification followed by behavioral counseling (abstinence-only approach) leads to relapse to opioids in most patients. An alternative approach is substitution therapy with the partial opioid receptor agonist buprenorphine, which is used for opioid maintenance in the primary care setting. This study investigated the patient characteristics associated with completion of 6-month buprenorphine/naloxone treatment in an ambulatory primary care office.
A retrospective chart review of 356 patients who received buprenorphine for treatment of opioid addiction was conducted. Patient characteristics were compared among completers and non-completers of 6-month buprenorphine treatment.
Of the 356 patients, 127 (35.7%) completed 6-month buprenorphine treatment. Completion of treatment was associated with counseling attendance and having had a past injury.
Future research needs to investigate the factors associated with counseling that influenced this improved outcome. Patients with a past injury might suffer from chronic pain, suggesting that buprenorphine might produce analgesia in addition to improving addiction outcome in these patients, rendering them more likely to complete 6-month buprenorphine treatment. Further research is required to test this hypothesis. Combination of behavioral and medical treatment needs to be investigated for primary care patients with opioid addiction and chronic pain.
阿片类药物成瘾在美国很普遍。脱毒后进行行为咨询（仅强调戒断的方法）会导致大多数患者重新使用阿片类药物。另一种替代方法是使用部分阿片受体激动剂丁丙诺啡进行替代疗法，这种方法用于初级保健环境中的阿片类药物维持治疗。本研究调查了与在门诊初级保健办公室完成 6 个月丁丙诺啡/纳洛酮治疗相关的患者特征。
对 356 名接受丁丙诺啡治疗阿片类药物成瘾的患者进行了回顾性图表审查。比较了完成和未完成 6 个月丁丙诺啡治疗的患者的特征。
在 356 名患者中，有 127 名（35.7%）完成了 6 个月的丁丙诺啡治疗。完成治疗与咨询就诊次数和过去受伤有关。
未来的研究需要调查与咨询相关的因素，这些因素影响了这一改善的结果。过去受伤的患者可能患有慢性疼痛，这表明丁丙诺啡除了改善这些患者的成瘾结果外，还可能产生镇痛作用，使他们更有可能完成 6 个月的丁丙诺啡治疗。需要进一步的研究来验证这一假设。对于有阿片类药物成瘾和慢性疼痛的初级保健患者，需要对行为和医疗治疗的组合进行研究。
