Opioid Addicted Buprenorphine Injectors: Drug Use During and After 12-Weeks of Buprenorphine-Naloxone or Methadone in the Republic of Georgia

Aims: The aim of this study is to assess the prevalence of non-opioid drug use among opioid-addicted, buprenorphine injecting individuals in Georgia, during and after a 12-week course of buprenorphine-naloxone (Suboxone (R)) or methadone. Methods: Randomized controlled trial with daily observed Suboxone (R) or methadone and weekly counseling, urine tests and timeline followback (TLFB) in weeks 0-12 and 20, and the Addiction Severity Index (ASI) at weeks 0, 4, 8, 12, 20. Results: Of the 80 patients (40/group, 4 women), 68 (85%) completed the 12-weeks of study treatment and 66 (82.5%) completed the 20-week follow-up. At baseline, injecting more than one drug in the last 30 days was reported by 68.4% of patients in the methadone and 72.5% in the Suboxone (R) groups. Drug use was markedly reduced in both treatment conditions but there were significant differences in the prevalence of specific drugs with more opioid (1.5 vs. 0.2%; p = 0.03), less amphetamine (0.2 vs. 2.8%; p < 0.001) and less marijuana (1.7 vs. 10.2%; p <0.001) positive urine tests in the methadone vs. Suboxone (R) groups. At the 20-week follow-up, TLFB results on the 34 that continued methadone or the 3 on Suboxone (R) showed less opioid (5.6 vs. 27.6%; p <0.001), illicit buprenorphine (2.7 vs. 13.8%; p = 0.005), benzodiazepine (13.5 vs. 34.5%; p <0.001), and marijuana (2.8 vs. 20.7%; p <0.001) use than the 29 who did not continue opioid substitution therapy. Conclusions: Despite small but significant differences in opioid and other drug use, both treatments were highly effective in reducing opioid and non-opioid drug use. (C) 2015 Elsevier Inc. All rights reserved.