TY - JOUR
KW - Buprenorphine, Naloxone Drug Combination
KW - Buprenorphine/therapeutic use
KW - Comorbidity
KW - Drug Combinations
KW - Humans
KW - Naloxone/therapeutic use
KW - Opioid-Related Disorders/drug therapy/epidemiology
KW - Primary Health Care/statistics & numerical data
KW - Retrospective Studies
KW - Self Administration/statistics & numerical data
AU - B. Doolittle
AU - W. Becker
A1 - 
AB - Physicians' adoption of buprenorphine/naloxone treatment is hindered by concerns over feasibility, cost, and lack of comfort treating patients with addiction. We examined the use of buprenorphine/naloxone in a community practice by two generalist physicians without addiction training, employing a retrospective chart review. From 2006-2010, 228 patients with opiate abuse/dependence were treated with buprenorphine/naloxone using a home-induction protocol. Multiple co-morbidities including diabetes (23% of patients), hypertension (36%), Hepatitis C (43%), and depression (74%) were concurrently managed. In this diverse sample, 1/228 experienced precipitated withdrawal during induction. Of the convenience subsample analyzed (n = 28), 82% (+/-10%) had negative urine drug tests for opioids; 92% (+/-11%) were negative for cocaine; 88% (+/-12%) were positive for buprenorphine. This case series demonstrated feasibility and safety of a low-cost buprenorphine/naloxone home induction protocol employed by generalists. Concurrent treatment of multiple comorbidities conforms with the patient-centered medical home ideal. Randomized trials of this promising approach are needed.
BT - Substance abuse
C5 - Opioids & Substance Use; Medical Home
CP - 4
CY - United States
DO - 10.1080/08897077.2011.599256
IS - 4
JF - Substance abuse
N2 - Physicians' adoption of buprenorphine/naloxone treatment is hindered by concerns over feasibility, cost, and lack of comfort treating patients with addiction. We examined the use of buprenorphine/naloxone in a community practice by two generalist physicians without addiction training, employing a retrospective chart review. From 2006-2010, 228 patients with opiate abuse/dependence were treated with buprenorphine/naloxone using a home-induction protocol. Multiple co-morbidities including diabetes (23% of patients), hypertension (36%), Hepatitis C (43%), and depression (74%) were concurrently managed. In this diverse sample, 1/228 experienced precipitated withdrawal during induction. Of the convenience subsample analyzed (n = 28), 82% (+/-10%) had negative urine drug tests for opioids; 92% (+/-11%) were negative for cocaine; 88% (+/-12%) were positive for buprenorphine. This case series demonstrated feasibility and safety of a low-cost buprenorphine/naloxone home induction protocol employed by generalists. Concurrent treatment of multiple comorbidities conforms with the patient-centered medical home ideal. Randomized trials of this promising approach are needed.
PP - United States
PY - 2011
SN - 1547-0164; 0889-7077
SP - 262
EP - 265
EP - 
T1 - A case series of buprenorphine/naloxone treatment in a primary care practice
T2 - Substance abuse
TI - A case series of buprenorphine/naloxone treatment in a primary care practice
U1 - Opioids & Substance Use; Medical Home
U2 - 22014257
U3 - 10.1080/08897077.2011.599256
VL - 32
VO - 1547-0164; 0889-7077
Y1 - 2011
ER -