Risk behaviors among patients on pharmacotherapies for opioid dependence

The relative safety of medication assisted therapy with methadone and buprenorphine has been established, and the benefits of these medications clearly outweigh the alternative of continued illicit opioid use. The opioid agonist, methadone, and partial agonist, buprenorphine, are associated with reductions in injection drug use, drug-related criminal activities, and incarcerations in opioid-dependent individuals. Exposure to HCV, HIV and STDs are among the major health concerns impacting this medically compromised population, and while there are significant reductions in risk behaviors associated with drug use during enrollment in medication assisted therapy, the reductions realized may be dependent upon the medication utilized. A randomized, open-label, multi-center, Phase 4 study conducted through the Clinical Trials Network (CTN) of the National Institute on Drug Abuse (NIDA) randomly assigned treatment-seeking opioid-dependent individuals to either methadone maintenance (MET) or buprenorphine and naloxone (BUP) for 24 weeks of pharmacotherapy. Participants were recruited at 1 of 8 treatment programs across the United States, and met DSM-IV criteria for opiate dependence. A total of 1269 participants were randomized to either buprenorphine (n = 740) or methadone (n = 529), were assessed on risk behaviors including injection drug use and high risk sexual behaviors using the Risk Behavior Survey (RBS) completed at intake, week 12, and week 24. A comparison of change in risk behavior between completers in the MET (391) and BUP (340) groups across the study duration will be presented and discussed.