Unobserved versus observed office buprenorphine/naloxone induction: a pilot randomized clinical trial.

Addictive Behaviors
Erik W GundersonFrances R Levin

Abstract

Physician adoption of buprenorphine treatment of opioid dependence may be limited in part by concerns regarding the induction process. Although national guidelines recommend observed induction, some physicians utilize unobserved induction outside the office. The aim of this pilot randomized clinical trial was to assess preliminary safety and effectiveness of unobserved versus observed office buprenorphine/naloxone induction among patients entering a 12-week primary care maintenance study. Participants (N=20) with DSM-IV opioid dependence were randomly assigned to unobserved or office induction, stratifying by past buprenorphine use. All patients received verbal and written instructions. A withdrawal scale was used during initiation and to monitor treatment response. Clinic visits occurred weekly for 4 weeks then decreased to monthly. The primary outcome, successful induction one week after the initial clinic visit, was defined as retention in buprenorphine/naloxone treatment and being withdrawal free. Secondary outcomes included prolonged withdrawal beyond 2 days after medication initiation and stabilization at week 4, defined as being in treatment without illicit opioid use for the preceding 2 weeks. Outcome results were simil...Continue Reading

References

Nov 1, 1978·The British Journal of Psychiatry : the Journal of Mental Science·R C YoungD A Meyer
Jan 1, 1992·Journal of Substance Abuse Treatment·A T McLellanM Argeriou
Jan 1, 1987·The American Journal of Drug and Alcohol Abuse·L HandelsmanP D Kanof
May 16, 2001·Archives of General Psychiatry·Y I HserM D Anglin
May 22, 2003·Drug and Alcohol Dependence·Nicholas LintzerisGreg Whelan
Aug 20, 2003·Journal of Psychoactive Drugs·Donald R Wesson, Walter Ling
Jan 1, 1959·The British Journal of Medical Psychology·M HAMILTON
Feb 1, 1960·Journal of Neurology, Neurosurgery, and Psychiatry·M HAMILTON
Nov 26, 2005·Journal of General Internal Medicine·Michael D SteinPeter D Friedmann
Jul 28, 2006·The New England Journal of Medicine·David A FiellinRichard S Schottenfeld
Dec 1, 2006·Substance Abuse : Official Publication of the Association for Medical Education and Research in Substance Abuse·Erik W GundersonHerbert D Kleber
Feb 20, 2007·Journal of Substance Abuse Treatment·Eric D CollinsEdward V Nunes
Mar 16, 2007·Journal of General Internal Medicine·Daniel P AlfordJeffrey H Samet
Mar 29, 2007·Annals of Family Medicine·Ira L MintzerSteffie Woolhandler
Jul 2, 2008·Journal of General Internal Medicine·Alexander Y WalleyDaniel P Alford
Aug 22, 2008·Journal of Substance Abuse Treatment·Julie NetherlandUNKNOWN BHIVES Collaborative
Dec 18, 2008·Journal of General Internal Medicine·Declan T BarryDavid A Fiellin
Dec 18, 2008·Journal of General Internal Medicine·Joshua D LeeMarc N Gourevitch
Jun 26, 2009·Journal of Substance Abuse Treatment·Janet M SoeffingDarius A Rastegar
Oct 6, 2009·Journal of Substance Abuse Treatment·Nancy L SohlerChinazo O Cunningham

❮ Previous
Next ❯

Citations

Feb 24, 2015·Substance Abuse : Official Publication of the Association for Medical Education and Research in Substance Abuse·Jeffrey D BaxterElizabeth O'Connell
Feb 24, 2018·Substance Abuse : Official Publication of the Association for Medical Education and Research in Substance Abuse·Marcus A BachhuberDavid Barclay
Jun 22, 2018·The Cochrane Database of Systematic Reviews·Afarin Rahimi-MovagharMasoumeh Amin-Esmaeili
Sep 26, 2014·Journal of Addiction Medicine·Joshua D LeeDavid A Fiellin
Apr 29, 2015·Journal of Addiction Medicine·Babak TofighiJoshua D Lee
Sep 26, 2014·Journal of Addiction Medicine·Joshua D LeeDavid A Fiellin
Mar 2, 2017·Addiction Science & Clinical Practice·Elenore Patterson BhatrajuJoshua D Lee
Dec 29, 2019·Addiction Science & Clinical Practice·Randi SokolZev Schuman-Olivier
Aug 16, 2011·The American Journal on Addictions·Erik W GundersonHerbert D Kleber
Aug 30, 2014·Expert Opinion on Pharmacotherapy·Xiaofan LiThomas R Kosten
May 21, 2021·BMJ : British Medical Journal·Megan BureshDarius Rastegar
Jun 12, 2021·International Journal of General Medicine·Joseph A Carley, Tyler Oesterle

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.