181317 Buprenorphine for the treatment of opioid dependence: A patient perspective

Monday, October 27, 2008: 4:30 PM

James E. Egan, MPH , Center for Urban Epidemiologic Studies (CUES), The New York Academy of Medicine, New York, NY
Jonathon Gass, MPH , Center for Urban Epidemiologic Studies (CUES), The New York Academy of Medicine, New York, NY
Julie Netherland, MSW , Division of Health Policy, The New York Academy of Medicine, New York, NY
Linda Weiss, PhD , Center for Evaluation, The New York Academy of Medicine, New York, NY
Background: Research has shown that buprenorphine (BPN) is a safe and effective office-based treatment for opioid dependence. Few reports, however, describe patient perspectives on this treatment. Our aim was to elicit patients' descriptions of attitudes and experiences with BPN. Methods: We conducted qualitative interviews (N=23) on drug use, cessation and treatment with patients participating in a HRSA-funded program integrating BPN into HIV care. Interview transcripts were reviewed and coded so that statements regarding perspectives and experience with BPN and other drug treatments could be carefully analyzed. Results: Participants commonly reported feeling “normal again” on BPN, that they did not feel as high as with methadone, and that they were able to reengage in previously abandoned activities such as work and time with family. Many commented on BPN's efficacy in blocking cravings and the effects of heroin, thereby helping to discourage use. Methadone, in contrast, not only allowed for continued heroin use but sometimes resulted in increases. Interestingly, several participants described a nuanced ability to self-manage BPN, including self-induction, dose changes, and intentionally stopping BPN treatment so they could reinitiate heroin use for a period of time. Most participants felt that individual and/or group counseling was an essential component of BPN treatment, which offered both practical and emotional supports. Satisfaction with BPN, office based treatment, and the reduced regulations were high, and even those who relapsed intended to begin treatment again. Discussion: These findings suggest that some patients see BPN as a viable and preferred form of opioid replacement therapy.

Learning Objectives:
1. Describe the potential for buprenorphine in the treatment of opioid dependence. 2. Describe the rationale for integrating buprenorphine treatment into HIV care settings. 3. Articulate patient perspectives on opioid replacement therapies

Keywords: Drug Abuse Treatment, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the project diretor of this study over the past few years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.