Influence of psychotherapy attendance on buprenorphine treatment outcome

Montoya, Iván D.; Schroeder, Jennifer R.; Preston, Kenzie L.; Covi, Lino; Umbricht, Annie; Contoreggi, Carlo; Fudala, Paul J.; Johnson, Rolley E.; Gorelick, David A.

doi:10.1016/j.jsat.2005.01.004

« Previous Next »Journal of Substance Abuse Treatment
Volume 28, Issue 3 , Pages 247-254, April 2005

Influence of psychotherapy attendance on buprenorphine treatment outcome

Iván D. Montoya, M.D., M.P.H.
- Division of Pharmacotherapies and Medical Consequences of Drug Abuse, National Institute on Drug Abuse, National Institutes of Health, Department of Health & Human Services, Rockville, MD 20892, USA
- Corresponding author. Division of Pharmacotherapies and Medical Consequences of Drug Abuse, National Institute on Drug Abuse, 6001 Executive Blvd. Bethesda, MD 20892-9551, USA. Tel.: +1-301-443-8639; fax: +1-301-443-2599.
Jennifer R. Schroeder, Ph.D.
- Clinical Pharmacology & Therapeutics Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Department of Health & Human Services, Baltimore, MD 21224, USA
Kenzie L. Preston, Ph.D.
- Clinical Pharmacology & Therapeutics Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Department of Health & Human Services, Baltimore, MD 21224, USA
Lino Covi, M.D.
- Clinical Pharmacology & Therapeutics Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Department of Health & Human Services, Baltimore, MD 21224, USA
Annie Umbricht, M.D.
- Clinical Pharmacology & Therapeutics Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Department of Health & Human Services, Baltimore, MD 21224, USA
Carlo Contoreggi, M.D.
- Brain Imaging Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Department of Health & Human Services, Baltimore, MD 21224, USA
Paul J. Fudala, Ph.D.
- University of Pennsylvania School of Medicine and the Veterans Affairs Medical Center, Philadelphia, PA 19104, USA
Rolley E. Johnson, Pharm.D.
- Reckitt Benckiser Pharmaceuticals, Inc. and Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD 21224, USA
David A. Gorelick, M.D., Ph.D.
- Clinical Pharmacology & Therapeutics Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Department of Health & Human Services, Baltimore, MD 21224, USA

Received 22 August 2004; received in revised form 22 August 2004; accepted 11 January 2005.

Abstract

We evaluated the influence of psychotherapy attendance on treatment outcome in 90 dually (cocaine and heroin) dependent outpatients who completed 70 days of a controlled clinical trial of sublingual buprenorphine (16 mg, 8 mg, or 2 mg daily, or 16 mg every other day) plus weekly individual standardized interpersonal cognitive psychotherapy. Treatment outcome was evaluated by quantitative urine benzoylecgonine (BZE) and morphine levels (log-transformed), performed three times per week. Repeated-measures linear regression was used to assess the effects of psychotherapy attendance (percent of visits kept), medication group, and study week on urine drug metabolite levels. Mean psychotherapy attendance was 71% of scheduled visits. Higher psychotherapy attendance was associated with lower urine BZE levels, and this association grew more pronounced as the study progressed (p = 0.04). The inverse relationship between psychotherapy attendance and urine morphine levels varied by medication group, being most pronounced for subjects receiving 16 mg every other day (p = 0.02). These results suggest that psychotherapy can improve the outcome of buprenorphine maintenance treatment for patients with dual (cocaine and opioid) dependence.

Keywords: Buprenorphine, Cocaine, Heroin, Dual dependence, Psychotherapy