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Short-Term Outcomes After Brief Ambulatory Opioid Detoxification With Buprenorphine in Young Heroin Users

NCJ Number
200592
Journal
Addiction Volume: 98 Issue: 4 Dated: April 2003 Pages: 453-462
Author(s)
Devang H. Gandhi; Jerome H. Jaffe; Scot McNary; Greg J. Kavanagh; Michael Hayes; Marian Currens
Date Published
April 2003
Length
10 pages
Annotation
This study examined the outcomes for 18-25-year-old heroin users after brief outpatient detoxification with buprenorphine; outcomes were measured at 1, 3, and 6 months after detoxification.
Abstract
The study participants were 123 male and female patients, 18-25 years old, who were currently using heroin and seeking buprenorphine detoxification treatment in Baltimore, MD, and surrounding counties. Participants were randomly assigned to receive either of two buprenorphine dose schedules: the "standard" dose of 2 mg sublingual (SL) tablet or 0.3 mg intramuscular (i.m.) injection and a "high" dose of 4 mg SL or 0.6 mg i.m. injection. Patients received buprenorphine over a 30-day period as allowed by the current U.S. Code of Federal Regulations in outpatient settings. All participants were asked to complete questionnaires at intake, daily for the first 5 days of treatment, and then at 1, 3, and 6 months after treatment. The study measured drug use history, addiction severity at index and follow-up, the detoxification experience, self-reported drug use, and drug use measured by urine testing. By self-report, 37 percent of the total sample were not using heroin at 1 month, 32 percent were not using at 3 months, and 29 percent were not using at 6 months. The urine test showed that 6.7 percent, 10.1 percent, and 11.8 percent had an opioid negative urine test at 1, 3, and 6 months, respectively. There was a significant reduction from the baseline in mean Addiction Severity Index drug use composite scores, as well as the mean number of days of heroin and cocaine use during the past 30 days; this was maintained over the three follow-up points. Involvement in aftercare was generally poor. Thus, the findings show a reduced frequency and intensity of drug use, suggesting a possible role for brief outpatient detoxification in reducing the severity of dependence for some younger heroin users who may not yet be ready to participate in long-term, abstinence-oriented or opioid substitution treatments. 2 tables, 1 figure, and 31 references

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