RESUMEN
Buprenorphine and methadone are both effective for the control of the acute signs and symptoms of opiate withdrawal, but it is not known if there are differences between these two medications for other important clinical outcomes. This observational, non-randomized study evaluated completion rates of patients over a 13-month period when buprenorphine replaced methadone as the medication used for short-term inpatient opiate detoxification. Of the 644 patients in the study, the 303 treated with buprenorphine were more likely to complete detoxification than the 341 treated with methadone (89% vs. 78%; P < .001). Improvement in completion rates coincided with the introduction of buprenorphine. We conclude that as compared to methadone, buprenorphine is associated with greater rates of completion of inpatient detoxification.
Asunto(s)
Buprenorfina/administración & dosificación , Metadona/administración & dosificación , Narcóticos/administración & dosificación , Trastornos Relacionados con Opioides/rehabilitación , Pacientes Desistentes del Tratamiento/estadística & datos numéricos , Adolescente , Adulto , Femenino , Estudios de Seguimiento , Hospitales de Enseñanza , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , New York , Trastornos Relacionados con Opioides/epidemiología , Centros de Tratamiento de Abuso de Sustancias , Síndrome de Abstinencia a Sustancias/rehabilitaciónRESUMEN
Additional treatment after inpatient detoxification is recommended; however, many patients fail to initiate aftercare. The purpose of this observational study was to determine which patients hospitalized for alcohol or drug withdrawal subsequently fail to initiate recommended outpatient aftercare treatment by using existing data from medical records. Of 406 patients, 180 (44.3%) did not initiate outpatient aftercare treatment after hospitalization for detoxification. Compared with those who did initiate aftercare, those who did not were less likely to have education beyond high school (44% vs. 32%; P = 0.018), to be enrolled in a managed care health insurance plan (46% vs. 34%; P = 0.013), and to have a family history of chemical dependency (81% vs. 72%; P = 0.049). These values were similar with multiple regression analysis. Of the 406 patients, 11 of 56 (20%) without any of these risk factors, 145 of 314 (46%) with 1 or 2 risk factors, and 24 of 36 (67%) with all 3 of these risk factors did not keep scheduled outpatient appointment for aftercare. These findings suggest that some patients admitted for inpatient detoxification, identifiable by certain admission characteristics, are at risk for failure to link with appropriate outpatient aftercare treatment.