ABSTRACT

Pathways to resolve the opioid epidemic focus on enhancing addiction treatment. Dropout rates from outpatient buprenorphine-naloxone (BN) treatment remain as high as 35% to 59%, contributing to poor treatment outcomes. Treatment interventions targeting retention require identification of dropout risk factors. This study used the New York State Office of Alcohol and Substance Abuse Services database to analyze patient information from an ancillary withdrawal management program. Binary logistic regression identified dropout trends. Use of alprazolam or cocaine and age (< 26 years old) correlated with increased likelihood of treatment drop-out. In contrast, a history of domestic violence or intimate partner violence, alcohol use, or prior hospitalization for a psychiatric disorder (hospital stay < 30 days) were associated with an increased likelihood of retention. Potentially modifiable dropout risk factors exist in BN treatment. Recommendations for treatment programs using BN treatment are included.

摘要

解决阿片类药物流行的途径重点在于加强成瘾治疗。门诊丁丙诺啡-纳洛酮（BN）治疗的辍学率仍然高达35％至59％，导致治疗效果差。针对保留的治疗干预措施需要确定辍学风险因素。这项研究使用了纽约州酒精与药物滥用服务办公室的数据库来分析辅助戒断管理程序中的患者信息。二元逻辑回归确定了辍学趋势。阿普唑仑或可卡因的使用和年龄（<26岁）与退出治疗的可能性增加相关。相比之下，有家庭暴力或亲密伴侣暴力，饮酒或因精神疾病而先住院的历史（医院住院< 30天）与保留可能性增加相关。BN治疗中存在潜在可修改的辍学危险因素。包括使用BN治疗的治疗方案的建议。