Vocci Frank J, Schwartz Robert P, Wilson Monique E, Gordon Michael S, Kinlock Timothy W, Fitzgerald Terrence T, O'Grady Kevin E, Jaffe Jerome H
Friends Research Institute, 1040 Park Avenue, Suite 103, Baltimore, MD 21201, USA.
Friends Research Institute, 1040 Park Avenue, Suite 103, Baltimore, MD 21201, USA.
Drug Alcohol Depend. 2015 Nov 1;156:133-138. doi: 10.1016/j.drugalcdep.2015.09.001. Epub 2015 Sep 7.
In a previously reported randomized controlled trial, formerly opioid-dependent prisoners were more likely to enter community drug abuse treatment when they were inducted in prison onto buprenorphine/naloxone (hereafter called buprenorphine) than when they received counseling without buprenorphine in prison (47.5% vs. 33.7%, p=0.012) (Gordon et al., 2014). In this communication we report on the results of the induction schedule and the adverse event profile seen in pre-release prisoners inducted onto buprenorphine.
This paper examines the dose induction procedure, a comparison of the proposed versus actual doses given per week, and side effects reported for 104 adult participants who were randomized to buprenorphine treatment in prison. Self-reported side effects were analyzed using generalized estimated equations to determine changes over time in side effects.
Study participants were inducted onto buprenorphine at a rate faster than the induction schedule. Of the 104 (72 males, 32 females) buprenorphine recipients, 64 (37 males, 27 females) remained on medication at release from prison. Nine participants (8.6%) discontinued buprenorphine because of unpleasant opioid side effects. There were no serious adverse events reported during the in-prison phase of the study. Constipation was the most frequent symptom reported (69 percent).
Our findings suggest that buprenorphine administered to non-opioid-tolerant adults should be started at a lower, individualized dose than customarily used for adults actively using opioids, and that non-opioid-tolerant pre-release prisoners can be successfully inducted onto therapeutic doses prior to release.
在之前报道的一项随机对照试验中，曾经对阿片类药物成瘾的囚犯在狱中开始使用丁丙诺啡/纳洛酮（以下简称丁丙诺啡）时，比在狱中接受无丁丙诺啡的咨询时更有可能进入社区药物滥用治疗项目（47.5% 对 33.7%，p = 0.012）（戈登等人，2014 年）。在本通讯中，我们报告了在即将获释的囚犯中使用丁丙诺啡的诱导方案结果和不良事件情况。
本文研究了剂量诱导程序、每周建议剂量与实际给予剂量的比较，以及104名被随机分配接受狱中丁丙诺啡治疗的成年参与者报告的副作用。使用广义估计方程分析自我报告的副作用，以确定副作用随时间的变化。
研究参与者接受丁丙诺啡诱导的速度快于诱导方案。在104名（72名男性，32名女性）丁丙诺啡接受者中，64名（37名男性，27名女性）在出狱时仍在用药。9名参与者（8.6%）因阿片类药物不愉快的副作用而停用丁丙诺啡。在研究的狱中阶段，未报告严重不良事件。便秘是报告最频繁的症状（69%）。
我们的研究结果表明，给予非阿片类药物耐受的成年人丁丙诺啡时，起始剂量应低于通常用于积极使用阿片类药物的成年人的个体化剂量，并且非阿片类药物耐受的即将获释囚犯可以在释放前成功诱导至治疗剂量。
