Comparison of the Risk of Drop-Out From Opioid Maintenance Treatment in Patients Using Naltrexone Implants Vs. Oral Buprenorphine-Naloxone

Abstract

Objective: Through increasing prevalence, opioid use disorder has been an important public health problem. The aim of this study is to compare the risk of drop-out from opioid use disorder maintenance treatment in patients using naltrexone implants vs. oral buprenorphine-naloxone, and to assess some sociodemographic and clinical correlates of drop-out. Method: The study has a retrospective-cohort design. All patients who completed the 21-days inpatient detoxification treatment between January 1st - November 1st, 2019 in a specialized alcohol and substance abuse treatment centre, and planned to be treated with either oral buprenorphine-naloxone or naltrexone implants were included in the study (n: 107). The associations between the drop-outs from the maintenance treatment and the treatment used (buprenorphine-naloxone or naltrexone implants), sociodemographic/clinical characteristics were assessed via multivariate cox regression. Results: No large or significant differences in sociodemographic and clinical characteristics were found between the two treatment groups. Both univariate and multivariate analysis showed no significant differences in the risk of drop-out from treatment between patients using oral buprenorphine-naloxone vs. naltrexone implants (Hazard Ratio: 1.39, %95CI: 0.82-2.35, p: 0.2). Multivariate analysis showed that presence of another substance use in addition to opioid use was significantly associated with the risk of drop-out (Hazard Ratio: 1,79, %95CI: 1,06-3,16, p: 0,04). Discussion: Results suggest no significant difference in the risk of drop-out from opioid maintenance treatment in patients using naltrexone implants vs. oral buprenorphine-naloxone. Additional substance use should be carefully considered while planning opioid use disorder maintenance treatment.