Buprenorphine/Naloxone - Results from the Private Practice Setting

Objective: Patients receiving office-based buprenorphine/naloxone maintenance treatment for opiate dependence were examined over a time span of 12 months in order to determine treatment efficacy, acceptance, tolerance and retention rates. Methods: An open-label, prospective multicenter trial (25 centres) was conducted including 307 patients with a DSM-IV diagnosis of opiate dependence with or without prior treatment. Study dropouts were analysed for predictors of treatment discontinuation. Results: The overall retention rate after 12 months was 45.6%. Patients with prior buprenorphine experience showed the highest retention rate. 3 significant predictors for premature study dropout were detected: a shorter duration of heroin dependence at study entrance (p = 0.038), younger age at initial drug exposure (p = 0.028) and a higher initial dose of maintenance medication (p=0.017). Two thirds of patients reported to be satisfied with treatment. However, self-assessment was not congruent with assessments provided by doctors. Conclusions: The study shows that there is a considerable need for further training concerning buprenorphine/naloxone treatment. Results on patient satisfaction and retention are comparable to other chronic conditions.