Influence of psychotherapy attendance on buprenorphine treatment outcome
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.
aDivision 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
bClinical 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
cBrain Imaging Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Department of Health & Human Services, Baltimore, MD 21224, USA
dUniversity of Pennsylvania School of Medicine and the Veterans Affairs Medical Center, Philadelphia, PA 19104, USA
eReckitt Benckiser Pharmaceuticals, Inc. and Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD 21224, 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.
ABSTRACT