Håkansson A, Widinghoff C, Abrahamsson T, Gedeon C
Department of Clinical Sciences Lund, Division of Psychiatry, Lund University, 221 85 Lund, Sweden; Malmö Addiction Center, Department of Psychiatry, 205 02 Malmö, Skane Region, Sweden.
Department of Clinical Sciences Lund, Division of Psychiatry, Lund University, 221 85 Lund, Sweden; Solstenen Outpatient Unit for Opiate Maintenance Treatment, Östra Mårtensgatan 15, 223 61 Lund, Sweden.
J Addict. 2016;2016:6487217. doi: 10.1155/2016/6487217. Epub 2016 Jan 21.
Interim medication-only treatment has been suggested for the initiation of opioid maintenance treatment (OMT) in opioid-dependent subjects, but this rarely has been studied using buprenorphine instead of methadone. Following a pilot trial assessing interim buprenorphine-naloxone treatment in order to facilitate transfer into OMT, we here aimed to study retention, and potential correlates of retention, in full-scale treatment. Thirty-six patients successfully referred from a waiting list through an interim treatment phase were followed for nine months in OMT. Baseline characteristics, as well as urine analyses during the interim phase and during full-scale OMT, were studied as potential correlates of retention. The nine-month retention in OMT was 83 percent (n = 30). While interim-phase urine samples positive for benzodiazepines did not significantly predict dropout from full-scale OMT (p = 0.09), urine samples positive for benzodiazepines within full-scale OMT were significantly associated with dropout (p < 0.01), in contrast to other substances and baseline characteristics. Retention remained high through nine months in this pilot study sample of patients referred through buprenorphine-naloxone interim treatment, but use of benzodiazepines is problematic, and the present data suggest that it may be associated with treatment dropout.
对于阿片类药物依赖者开始阿片类药物维持治疗(OMT),有人建议采用仅进行临时药物治疗的方法,但很少有研究使用丁丙诺啡而非美沙酮来开展此项治疗。在一项评估临时丁丙诺啡 - 纳洛酮治疗以促进转入OMT的试点试验之后,我们在此旨在研究全面治疗中的留存率以及留存率的潜在相关因素。36名通过临时治疗阶段从等候名单中成功转诊的患者在OMT中接受了9个月的随访。研究了基线特征以及临时阶段和全面OMT期间的尿液分析结果,将其作为留存率的潜在相关因素。OMT中的9个月留存率为83%(n = 30)。虽然临时阶段苯二氮䓬类药物检测呈阳性的尿液样本并不能显著预测在全面OMT中退出治疗的情况(p = 0.09),但与其他物质和基线特征相比,全面OMT期间苯二氮䓬类药物检测呈阳性的尿液样本与退出治疗显著相关(p < 0.01)。在这项通过丁丙诺啡 - 纳洛酮临时治疗转诊的患者试点研究样本中,9个月内的留存率仍然很高,但苯二氮䓬类药物的使用存在问题,目前的数据表明其可能与治疗退出有关。