Factors Associated with Buprenorphine Discontinuation Discovered

Many individuals who have opioid use disorder do not seek treatment due to various reasons, including the fear of stigma associated with the condition, but for those who do seek treatment, adherence to treatment programs may prove difficult. For successful treatment, adherence to the substance abuse drug buprenorphine is critical to prevent relapses and overdoses.

Researchers in a new study, published by the Journal of Substance Abuse Treatment, discovered multiple factors that may impact adherence to buprenorphine treatment. Findings suggest that individuals who are black, Hispanic, unemployed, or have who hepatitis C virus (HCV) are more likely to discontinue treatment.

Buprenorphine is an effective treatment for opioid use disorder, and is associated with reduced usage of heroin and prescription opioids. This treatment may also lead to reduced engagement in risky behaviors, such as those that may cause an individual to develop HIV or HCV.

In the current study, investigators set out to determine the factors that were associated with treatment discontinuation to strengthen strategies that improve adherence.

Included in the study were 1200 patients treated by Boston Medical Center’s office-based addiction treatment program between 2002 and 2014. Patients were followed for 12 years, with the aim of discovering factors associated with remaining in the treatment program for longer than 1 year, according to the study.

The investigators assessed age, gender, race/ethnicity, education, employment, HCV status, psychiatric conditions, and prior/current use of alcohol or drugs.

Patients who were older, female, and had comorbid psychiatric conditions were more likely to remain in the treatment program for longer than 1 year, according to the study. However, those who were black or Hispanic, unemployment, or who had HCV were not likely to surpass 1 year in treatment.

The investigators said that determining the factors that impact treatment discontinuation is critical due to the increased efforts that researchers and the government are making due to the increase in the amount of individuals with opioid use disorder. States like New Jersey created novel initiatives to combat opioid addiction, such as banning fentanyl knock-offs and expanding their Recovery Coach Program, which provides individuals with a support system.

These new findings suggest that expanding certain seemingly unrelated programs may present states with novel ways to combat the epidemic. Widespread treatment for HCV may improve adherence to treatment programs, and save money in the long-term due to offsetting costs from cirrhosis, and hepatocellular carcinoma, which are common among patients with this disease.

The researchers suggest that expanding employment assistance programs may help keep patients involved with treatment programs for longer periods of times, according to the study.

"This study highlights some important disparities in treatment outcomes, especially racial/ethnic disparities in outcomes, which reflect a larger issue in medical care in general as well as in society at large," said lead author Zoe Weinstein, MD.