Drug treatment outcomes among HIV-infected opioid-dependent patients receiving buprenorphine/naloxone

David A. Fiellin, Linda Weiss, Michael Botsko, James E. Egan, Frederick L. Altice, Lauri B. Bazerman, Amina Chaudhry, Chinazo O. Cunningham, Marc N. Gourevitch, Paula J. Lum, Lynn E. Sullivan, Richard S. Schottenfeld, Patrick G. O'Connor

Research output: Contribution to journalArticlepeer-review

76 Scopus citations

Abstract

Background: Buprenorphine/naloxone allows the integration of opioid dependence and HIV treatment. Methods: We conducted a prospective study in HIV-infected opioid-dependent patients to investigate the impact of buprenorphine/naloxone treatment on drug use. Self-report and chart review assessments were conducted every 3 months (quarters 1-4) for 1 year. Outcomes were buprenorphine/naloxone treatment retention, drug use, and addiction treatment processes. Results: Among 303 patients enrolled between July 2005 and December 2007, retention in buprenorphine/naloxone treatment was 74%, 67%, 59%, and 49% during Quarters 1, 2, 3, and 4, respectively. Past 30-day illicit opioid use decreased from 84% of patients at baseline to 42% in retained patients over the year. Patients were 52% less likely to use illicit opioids for each quarter in treatment (Odds ratio = 0.66; 95% CI: 0.61 to 0.72). Buprenorphine/naloxone doses and office visits approximated guidelines published by the United States Department of Health and Human Services. Urine toxicology monitoring was less frequent than recommended. Conclusions: Buprenorphine/naloxone provided in HIV treatment settings can decrease opioid use. Strategies are needed to improve retention and address ongoing drug use in this treatment population.

Original languageEnglish (US)
Pages (from-to)S33-S38
JournalJournal of Acquired Immune Deficiency Syndromes
Volume56
Issue numberSUPPL. 1
DOIs
StatePublished - Mar 1 2011

Keywords

  • Buprenorphine
  • HIV
  • heroin dependence
  • methadone
  • opioid-related disorders

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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