NIDA Study Focuses on ERs, Buprenorphine and Follow-Up Care
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The National Institute on Drug Abuse (NIDA) has highlighted a new emergency departments research study on the treatments of patients with opioid dependence.
Traditionally, beyond attempts at providing a brief intervention, the main treatment offered to opioid dependent patients in emergency departments has been referrals to local addiction treatment options. Unfortunately, such a treatment approach resulted in limited success at best. The new study shows that a combination of the medication buprenorphine with ongoing care is much more effective.
The randomized clinical trial showed that patients who received buprenorphine and up to 12 weeks of buprenorphine maintenance were more likely to get follow-up addiction treatment, and had reduced self-reported opioid misuse and abuse. Buprenorphine is a treatment for opioid use disorder that decreases withdrawal, craving, and overall drug use. The initial dosage of the medication was combined with a brief intervention to discuss the patient’s opioid use, including their drug history and the subsequent dangers.
In the study, over 300 patients with opioid dependence issues were examined at an urban teaching hospital over a period of three years. Although self-reporting of drug use played an important role in the study, the patients were also urine-tested during the follow-up sessions when the buprenorphine was administered. After such outpatient treatment, the patients were also less likely to need inpatient addiction treatment services, saving treatment costs. The researchers note that their findings require replication in other centers before widespread adoption is recommended.
As the study expressed in its concluding statement, “Among opioid-dependent patients presenting for emergency care, ED-initiated buprenorphine, compared with brief intervention and referral, significantly increased engagement in formal addiction treatment, reduced self-reported illicit opioid use, and decreased use of inpatient addiction treatment services but did not significantly decrease the rates of positive urine testing for opioids or HIV risk.”
According to NIDA, the study adds to the growing body of literature suggesting that opioid-dependent patients may benefit from immediate initiation of medication. Although NIDA still recommends that comprehensive substance use disorder treatment in the form of either an in-patient rehab or out-patient therapy be sought by such patients, the immediate introduction of buprenorphine is most likely a remarkably improved way to start the process of recovery.