Objective: Illicit opioids such as heroin are among the most common form of illicit drug use worldwide. Buprenorphine–naloxone treatment of patients dependent on heroin has been reported to be more effective than placebo. This treatment allows clinicians to initiate and manage the treatment of opioid-dependent patients directly in the outpatient clinics. Up to now, no studies have examined factors associated with relapse and treatment retention in opioid dependent outpatients in Turkey. The goal of this study was to evaluate the predictors of three months compliance rate with buprenorphine-naloxone treatment among a sample of patients with opioid addiction.
Methods: A retrospective chart review of 60 patients with opioid addiction treated at the Akdeniz University, Alcohol and Substance Addiction Treatment and Research Center was conducted. Medical records of the patients were accessed via the center’s database. We evaluated he records of patients who sought and had received any treatment with buprenorphine‐naloxone for opioid addiction in the center from September 1, 2013 to November 31, 2013. Records were reviewed from the beginning of a patient’s opioid treatment, through January 31, 2014, to ensure an opportunity for at least three months of data collection, even if the patient dropped out of treatment. Relevant data such as sociodemographic variables, drug use history, and opioid use patterns were gathered from the records. Normality of the data was tested using the Kolmogorov–Smirnov test. If distributed normally, data were shown as means and standard deviations and compared with Student’s t-test. Non-normally distributed data were described as median (25th percentile; 75th percentile). The non-parametric Mann–Whitney U test was used to detect differences in non-normally distributed continuous variables between two groups. Categorical variables were compared using chi-square test.
Results: The mean (±standard deviation) age of the study population was 25.7±6.7 years. There were only four (6.5%) females in the cohort. Most of the patients were single (78.3%) and unemployed (65%). At least three months after buprenorphine–naloxone maintenance treatment, relapse rate was 66.6%.
Conclusions: Our results suggested patients, who were never married and those with an education of less than 8 years were more likely to relapse to opioid use. We also found a relationship between average daily heroin dose and poor outcome as reşected by illicit opioid use during treatment. The reason for this finding may be the increased need for substitution treatment among heroin dependent patients who use higher doses. Future research is needed to determine whether modifying these factors may lead to improved treatment outcomes.