Adherence, Not Regimen, Key for Opioid Addiction

Patients who adhered to counseling and buprenorphine-naloxone had lower opioid use

WEDNESDAY, July 26 (HealthDay News) -- A variety of weekly regimens involving counseling and buprenorphine-naloxone appear to be equally effective in reducing opioid use among dependent patients, with patients who adhere to their medication more likely to remain drug-free regardless of treatment schedule, according to a report in the July 27 issue of the New England Journal of Medicine.

David A. Fiellin, M.D., and colleagues from Yale University School of Medicine in New Haven, Conn., conducted a 24-week controlled trial where 166 patients with opioid dependence were randomized to standard medical management with medication dispensing once a week, three times a week, or enhanced care with medication dispensed three times a week.

The three treatments were equally effective with respect to the number of opioid-free urine specimens collected and maximum number of weeks abstained, and caused a similar reduction in opioid use compared with baseline. Dropout rates for each were similar as well. While adherence to medication averaged at about 71 percent and also did not differ significantly between the groups, a higher adherence rate correlated with more opioid-free weeks.

"The variability in buprenorphine-naloxone adherence highlights the need both to measure adherence in future research and to monitor and encourage adherence in practice in order to reduce the potential misuse of the medication and to improve the treatment outcomes," the authors write.

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