New research comparing treatment approaches for opioid-dependent patients in emergency departments (ED) suggests that combining the medication buprenorphine with ongoing care is more effective than simply providing referrals to addiction treatment, with or without a brief intervention. This study showed that patients who received buprenorphine, along with a brief intervention to discuss opioid use, and up to 12 weeks of buprenorphine maintenance, were more likely to get follow-up addiction treatment and had reduced self-reported illicit opioid use. In addition, they were also less likely to need inpatient addiction treatment services, saving treatment costs. This adds to the growing body of literature suggesting that opioid-dependent patients may benefit from immediate initiation of medication while awaiting more comprehensive substance use disorder treatment.
This research was funded by NIDA. For a copy of the article, published in JAMA, go to: http://jama.jamanetwork.com/article.aspx?articleid=2279713.
The researchers conducted a follow-up study to evaluate the long term outcomes (2, 6 and 12 months) after providing buprenorphine to patients in the Emergency Department with continuation in primary care. A total of 290/329 participants (88% of the randomized sample) were included. Results showed that patients who received buprenorphine in the Emergency Department, and follow up in primary care over 10 weeks, were more likely to be engaged in addiction treatment and to report reduced use of opioids after two months. However, this intervention did not produce significant reductions in either engagement in treatment or opioid use at 6 or 12 months. The authors concluded that the findings add to the evidence that initiating treatment with medication in the Emergency Department, and continued treatment in primary care for patients, improves outcomes for patients with opioid use disorder as long as the intervention is continued.
For a copy of the abstract, "Emergency Department-Initiated Buprenorphine for Opioid Dependence with Continuation in Primary Care: Outcomes During and After Intervention," published in the Journal of General Internal Medicine, go to http://link.springer.com/article/10.1007/s11606-017-3993-2.
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