Like other chronic, life-long medical conditions such as
hypertension or diabetes, opioid use disorder (OUD) requires long-term
engagement in therapy for its success.
Buprenorphine (also known as Subutex, or Suboxone when formulated
with another drug, naloxone) is an effective treatment for opioid
dependence. Treatment with buprenorphine has been shown to lead to
reduced rates of heroin and prescription opioid use, as well as a
reduction in "risky behaviors" that are associated with development of
significant co-morbidities such as HIV or viral hepatitis infection.
‘Individuals with opioid use disorder who are treated with buprenorphine are more likely to disengage from treatment programs if they are black or Hispanic, unemployed, or have hepatitis C.’
According to the experts, many
individuals who participate in Office Based Addiction Treatment (OBAT)
with buprenorphine discontinue treatment less than one year after
Individuals with opioid use disorder who are treated with
buprenorphine are more
likely to disengage from treatment programs if they are black or
Hispanic, unemployed, or have hepatitis C, revealed a study published
online in the Journal of Substance Abuse Treatment
.To better understand the reasons for disengagement from
buprenorphine treatment, researchers from Boston University Schools of
Medicine (BUSM) and (BUSPH) Public Health examined patients treated at
Boston Medical Center's (BMC) OBAT program between 2002 and 2014.
observational study followed more than 1,200 patients over 12 years with
the goal of identifying patient-specific factors associated with
retention in the treatment program for longer than one year. It
specifically evaluated age, gender, race/ethnicity, education level,
employment, infection with hepatitis C virus, co-morbid psychiatric
conditions, and prior or current use of drugs or alcohol.
While the study found that older age, female, and co-morbid
psychiatric diagnosis were associated with greater odds of treatment
retention beyond one year, patients who were black or Hispanic,
unemployed, and had evidence of hepatitis C viral infection were
associated with decreased odds of treatment retention beyond one year.
"This study highlights some important disparities in treatment
outcomes, especially racial/ethnic disparities in outcomes, which
reflect a larger issue in medical care in general as well as in society
at large," explained lead author Zoe Weinstein, assistant professor
of medicine at BUSM and director of the Addiction Consult Service at
BMC. She points out that identifying risk factors for disengagement is
especially important given the increased focus from researchers and
clinicians to expand access to treatment with opioid agonist, such as
buprenorphine, in light of the current opioid epidemic.
The authors argue that the results highlight new avenues of
exploration to improve current strategies of treating addiction. For
instance, the authors suggest that employment assistance programs may
help retain patients in recovery programs by engaging them in work.