TY - JOUR
KW - Abstinence
KW - Buprenorphine, Naloxone Drug Combination/urine
KW - buprenorphine/naloxone
KW - Compliance
KW - Drug Monitoring/statistics & numerical data
KW - Humans
KW - Narcotic Antagonists/urine
KW - Opiate Substitution Treatment
KW - opioid maintenance therapy programs
KW - Patient Compliance/statistics & numerical data
KW - Street Drugs/urine
KW - substance-use disorder
KW - United States
KW - urine drug screens
AU - K. Blum
AU - D. Han
AU - E. J. Modestino
AU - S. Saunders
AU - A. K. Roy III
AU - W. Jacobs
AU - D. S. Inaba
AU - D. Baron
AU - M. Oscar-Berman
AU - M. Hauser
AU - R. D. Badgaiyan
AU - D. E. Smith
AU - J. Femino
AU - M. S. Gold
A1 - 
AB - BACKGROUND: Buprenorphine and naloxone (bup/nal), a combination partial mu receptor agonist and low-dose delta mu antagonist, is presently recommended and used to treat opioid-use disorder. However, a literature review revealed a paucity of research involving data from urine drug tests that looked at compliance and abstinence in one sample. METHOD: Statistical analysis of data from the Comprehensive Analysis of Reported Drugs (CARD) was used to assess compliance and abstinence during treatment in a large cohort of bup/nal patients attending chemical-dependency programs from eastern USA in 2010 and 2011. RESULTS: Part 1: Bup/nal was present in 93.4% of first (n = 1,282; p <.0001) and 92.4% of last (n = 1,268; p <.0001) urine samples. Concomitantly, unreported illicit drugs were present in 47.7% (n = 655, p =.0261) of samples. Patients who were compliant to the bup/nal prescription were more likely than noncompliant patients to be abstinent during treatment (p =.0012; odds ratio = 1.69 with 95% confidence interval (1.210, 2.354). Part 2: An analysis of all samples collected in 2011 revealed a significant improvement in both compliance (p < 2.2 x 10(-16)) and abstinence (p < 2.2 x 10(-16)) during treatment. Conclusion/Importance: While significant use of illicit opioids during treatment with bup/nal is present, improvements in abstinence and high compliance during maintenance-assisted therapy programs may ameliorate fears of diversion in comprehensive programs. Expanded clinical datasets, the treatment modality, location, and year of sampling are important covariates, for further studies. The potential for long-term antireward effects from bup/nal use requires consideration in future investigations.
BT - Substance use & misuse
C5 - Opioids & Substance Use
CP - 2
CY - England
DO - 10.1080/10826084.2017.1400064
IS - 2
JF - Substance use & misuse
N2 - BACKGROUND: Buprenorphine and naloxone (bup/nal), a combination partial mu receptor agonist and low-dose delta mu antagonist, is presently recommended and used to treat opioid-use disorder. However, a literature review revealed a paucity of research involving data from urine drug tests that looked at compliance and abstinence in one sample. METHOD: Statistical analysis of data from the Comprehensive Analysis of Reported Drugs (CARD) was used to assess compliance and abstinence during treatment in a large cohort of bup/nal patients attending chemical-dependency programs from eastern USA in 2010 and 2011. RESULTS: Part 1: Bup/nal was present in 93.4% of first (n = 1,282; p <.0001) and 92.4% of last (n = 1,268; p <.0001) urine samples. Concomitantly, unreported illicit drugs were present in 47.7% (n = 655, p =.0261) of samples. Patients who were compliant to the bup/nal prescription were more likely than noncompliant patients to be abstinent during treatment (p =.0012; odds ratio = 1.69 with 95% confidence interval (1.210, 2.354). Part 2: An analysis of all samples collected in 2011 revealed a significant improvement in both compliance (p < 2.2 x 10(-16)) and abstinence (p < 2.2 x 10(-16)) during treatment. Conclusion/Importance: While significant use of illicit opioids during treatment with bup/nal is present, improvements in abstinence and high compliance during maintenance-assisted therapy programs may ameliorate fears of diversion in comprehensive programs. Expanded clinical datasets, the treatment modality, location, and year of sampling are important covariates, for further studies. The potential for long-term antireward effects from bup/nal use requires consideration in future investigations.
PP - England
PY - 2018
SN - 1532-2491; 1082-6084
SP - 220
EP - 229
EP - 
T1 - A Systematic, Intensive Statistical Investigation of Data from the Comprehensive Analysis of Reported Drugs (CARD) for Compliance and Illicit Opioid Abstinence in Substance Addiction Treatment with Buprenorphine/naloxone
T2 - Substance use & misuse
TI - A Systematic, Intensive Statistical Investigation of Data from the Comprehensive Analysis of Reported Drugs (CARD) for Compliance and Illicit Opioid Abstinence in Substance Addiction Treatment with Buprenorphine/naloxone
U1 - Opioids & Substance Use
U2 - 29257919
U3 - 10.1080/10826084.2017.1400064
VL - 53
VO - 1532-2491; 1082-6084
Y1 - 2018
ER -