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The Association between Cocaine Use and Treatment Outcomes in Patients Receiving Office‐Based Buprenorphine/Naloxone for the Treatment of Opioid Dependence

2009; Wiley; Volume: 19; Issue: 1 Linguagem: Inglês

10.1111/j.1521-0391.2009.00003.x

1521-0391

Lynn E. Sullivan, Brent A. Moore, Patrick G. O’Connor, Declan T. Barry, Marek C. Chawarski, Richard S. Schottenfeld, David A. Fiellin,

Substance Abuse Treatment and Outcomes

Cocaine use in patients receiving methadone is associated with worse treatment outcomes. The association between cocaine use and office-based buprenorphine/naloxone treatment outcomes is not known. We evaluated the association between baseline and in-treatment cocaine use, treatment retention, and urine toxicology results in 162 patients enrolled in a 24-week trial of primary care office-based buprenorphine/naloxone maintenance. Patients with baseline cocaine metabolite-negative urine toxicology tests compared with those with cocaine metabolite-positive tests had more mean weeks of treatment retention (18.3 vs. 15.8, p = .04), a greater percentage completed 24 weeks of treatment (50% vs. 33%, p = .04) and had a greater percentage of opioid-negative urines (47% vs. 34%, p = .02). Patients with in-treatment cocaine metabolite-negative urine toxicology tests compared with cocaine metabolite-positive patients had more mean weeks of treatment retention (19.0 vs. 16.5, p = .003), a greater percentage completed 24 weeks of treatment (60% vs. 30%, p < .001), and had a greater percentage of opioid-negative urines (51% vs. 35%, p = .001). We conclude that both baseline and in-treatment cocaine use is associated with worse treatment outcomes in patients receiving office-based buprenorphine/naloxone and may benefit from targeted interventions.