A chart review based comparative study of retention rates for two dispensing regimens for buprenorphine for subjects with opioid dependence at a tertiary care substance use disorder treatment center

Yatan Pal Singh Balhara, MD, DNB, MNAMS

doi:10.5055/jom.2014.0208

Authors

Yatan Pal Singh Balhara, MD, DNB, MNAMS

DOI:

https://doi.org/10.5055/jom.2014.0208

Keywords:

alternate-day dispensing, buprenorphine, daily dispensing, urinalysis

Abstract

Objective: The current study aimed at comparison of retention rates for daily dispensing (DD) and alternate-day dispensing (AD) regimens for buprenorphine over a 1-year period at a tertiary care treatment center for management of substance use disorders. Additionally, it aimed at comparison of prescription refill proportions for these two buprenorphine dispensing regimens over a 1-year period.

Setting: The study was conducted at a tertiary level substance use disorder treatment center.

Patients, participants: Case records of patients satisfying the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria for opioid dependence syndrome were included in the study.

Main outcome measures: Retention rates and prescription refill proportions were compared for the two buprenorphine dispensing regimens for different time intervals over a 52-week period.

Results: Fifty-two subjects (45.61 percent) were started on DD regimen and 62 (54.38 percent) were put on AD regimen of buprenorphine. All subjects were opioid dependent. The two groups did not differ for prescription refill proportions as well as retention rates for any of the time intervals studied.

Conclusion: The findings of the current study support feasibility and acceptance of alternate-day dosing strategy for buprenorphine dispensing for patients with opioid dependence.

Author Biography

Yatan Pal Singh Balhara, MD, DNB, MNAMS

Assistant Professor of Psychiatry, Department of Psychiatry and National Drug Dependence Treatment Centre (NDDTC), All India Institute of Medical Sciences (AIIMS), New Delhi, India.

References

Ponizovsky AM, Margolis A, Heled L, et al.: Improved quality of life, clinical, and psychosocial outcomes among heroin-dependent patients on ambulatory buprenorphine maintenance. Subst Use Misuse. 2010; 45 (1-2): 288 - 313.

Balhara YP, Jain R: Urinalysis-based comparative evaluation of pattern of use of dextropropoxyphene and buprenorphine among opioid-dependent subjects. J Opioid Manag. 2012; 8 (1): 45 - 49.

Balhara YP, Jain R: A urinalysis-based study of buprenorphine and non-prescription opioid use among patients on

buprenorphine maintenance. J Pharmacol Pharmacother. 2012; 3 (1): 15 - 19.

Carrieri MP, Amass L, Lucas GM, et al.: Buprenorphine use: The international experience. Clin Infect Dis. 2006; 43 (Suppl 4): S197 - S215.

Department of Health, Scottish Office Department of Health, Welsh Office; Department of Health and Social Services, Northern Ireland: Drug Misuse and Dependence. Guidelines on Clinical Management. Norwich: Department of Health. HMSO, 1999.

Ho RCM, Chen KY, Broekman B, et al.: Buprenorphine prescription, misuse and service provision: A global perspective global perspective. Adv Psychiatr Treat. 2009; 15: 354 - 363.

Hurley M: Methadone and Buprenorphine Guidelines for Pharmacists in South Australia. South Australia: Drug & Alcohol Services, 2004, revised 2006, revised 2010. Available at http://www.sahealth.sa.gov.au/wps/wcm/connect/8875c9804008e393b7ffbf4826472d56/Methadone+and+Buprenorphine+Guidelines+for+Pharmacists+in+SA-DASSA-Feb2013.pdf?MOD=AJPERES&CACHEID=8875c9804008e393b7ffbf4826472d56. Accessed March 19, 2014.

Thirion X, Lapierre V, Micallef J, et al.: Buprenorphine prescription by general practitioners in a French region. Drug Alcohol Depend. 2002; 65 (2): 197 - 204.

Strang J, Manning V, Mayet S, et al.: Does prescribing for opiate addiction change after national guidelines?. Methadone and buprenorphine prescribing to opiate addicts by general practitioners and hospital doctors in England, 1995-2005. Addiction. 2007; 102 (5): 761 - 770.

Fudala PJ, Jaffe JH, Dax EM, et al.: Use of buprenorphine in the treatment of opioid addiction. II. Physiologic and behavioral effects of daily and alternate-day administration and abrupt withdrawal. Clin Pharmacol Ther. 1990; 47 (4): 525 - 534.

Johnson RE, Eissenberg T, Stitzer ML, et al.: Buprenorphine treatment of opioid dependence: Clinical trial of daily versus alternate-day dosing. Drug Alcohol Depend. 1995; 40 (1): 27 - 35.

Amass L, Bickel WK, Crean JP, et al.: Alternate-day buprenorphine dosing is preferred to daily dosing by opioid-dependent humans. Psychopharmacology (Berl). 1998; 136 (3): 217 - 225.

Amass L, Bickel WK, Higgins ST, et al.: Alternate-day dosing during buprenorphine treatment of opioid dependence. Life Sci. 1994; 54 (17): 1215 - 1228.

Marsch LA, Bickel WK, Badger GJ, et al.: Buprenorphine treatment for opioid dependence: The relative efficacy of daily, twice and thrice weekly dosing. Drug Alcohol Depend. 2005; 77 (2): 195 - 204.

Petry NM, Bickel WK, Badger GJ: A comparison of four buprenorphine dosing regimens in the treatment of opioid dependence. Clin Pharmacol Ther. 1999; 66 (3): 306 - 314.

Schottenfeld RS, Pakes J, O'Connor P, et al.: Thrice-weekly versus daily buprenorphine maintenance. Biol Psychiatry. 2000; 47 (12): 1072 - 1079.

Walsh SL, Preston KL, Bigelow GE, et al.: Acute administration of buprenorphine in humans: Partial agonist and blockade effects. J Pharmacol Exp Ther. 1995; 274 (1): 361 - 372.

Mattick RP, Kimber J, Breen C, et al.: Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence. Cochrane Database Syst Rev. 2008; (2): CD002207.

Kintz P: Deaths involving buprenorphine: A compendium of French cases. Forensic Sci Int. 2001; 121: 65 - 69.

Petry NM, Bickel WK, Badger GJ: A comparison of four buprenorphine dosing regimens using open-dosing procedures: Is twice-weekly dosing possible? Addiction. 2000; 95 (7): 1069 - 1077.

Mohan D, Dhawan A, Chopra A, et al.: A 24-week outcome following buprenorphine maintenance among opiate users in India. J Subst Use. 2006; 11 (6): 409 - 415.

Dhawan A, Chopra A: Does buprenorphine maintenance improve the quality of life of opioid users? Indian J Med Res. 2013; 137 (1): 130 - 135.