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NEWS FROM CAMBRIDGE HEALTH ALLIANCE

March 27, 2007

Harvard Researchers at Cambridge Health Alliance Find Opioid Addiction Can Be Treated in Community-Based Primary Care Settings

Research Alert

Study Title: Treating Opioid Addiction With Buprenorphine-Naloxone in Community-Based Primary Care Settings

Objectives: The authors examined the efficacy and practicality of buprenorphine-naloxone treatment in primary care settings.

Methods: The authors studied a group of 99 consecutive patients enrolled in buprenorphine-naloxone (hereafter referred to as buprenorphine) treatment for opioid dependence at two urban primary care practices: a hospital-based primary care clinic, and a primary care practice in a neighborhood health center. The primary outcome measure was sobriety at six months as judged by the treating physician based on periodic urine drug tests, as well as frequent physical examinations and questioning of the patients about substance use.

Findings: 54% of patients were sober at six months. Sobriety was correlated with private insurance status, older age, length of treatment, and attending self-help meetings. There was no significant correlation between sobriety and site of care, drug of choice, neighborhood poverty level, or dose of buprenorphine.

Impact: Opioid-addicted patients can be safely and effectively treated in non-research primary care settings with limited on-site resources. The authors’ findings suggest that a greater number of patients should have access to buprenorphine treatment in non-specialized settings.

Background: An opioid is a chemical substance commonly used for pain relief, such as methadone or oxycodone. While office-based treatment of opioid addiction with buprenorphine and naloxone was approved in 2002, few studies have documented the outcomes of buprenorphine treatment outside of resource-rich research settings.  

Authors: Ira L. Mintzer, MD, Medical Director of the Primary Care Center at The Cambridge Hospital campus of Cambridge Health Alliance and Assistant Professor of Medicine at Harvard Medical School; Mark Eisenberg, MD, Unit Chief of the MGH Charlestown HealthCare Center and Instructor in Medicine at Harvard Medical School; Maria Terra, BA, an interpreter at Cambridge Health Alliance; Casey MacVane, MD, MPH, an emergency medicine resident at Maine Medical Center; David U. Himmelstein, MD, Chief of the Division of Social and Community Medicine at Cambridge Health Alliance and Associate Professor of Medicine at Harvard Medical School; and Steffie Woolhandler, MD, a physician at Cambridge Health Alliance and Associate Professor of Medicine at Harvard Medical School.

Journal: Annals of Family Medicine, March/April 2007, Vol. 5, No. 2 Website: www.annfammed.org

Cambridge Health Alliance is a regional healthcare system with three hospitals and more than twenty primary care practices in Cambridge, Somerville, and Boston's metro-North communities. As a teaching affiliate of Harvard Medical School, Cambridge Health Alliance offers medical residency/training programs and undergraduate learning experiences in hospital and community settings. Cambridge Health Alliance also includes the Cambridge Public Health Department, CHA Physicians Organization (CHAPO), and Network Health, a managed Medicaid plan.

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Alison Harris
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aharris@challiance.org

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