I recently came across this 2014 study of 220 buprenorphine patients.
I mentioned it in another post and noted this sentence from the conclusion as underwhelming, “The number of legal charges for drug possession decreased from 70 to 62.”
Turns out that this sentence casts their outcomes in a misleadingly positive light. In the year before buprenorphine subjects were charged with 221 crimes. In the year following initiation of buprenorphine, they were charged with 237.
Though cumulatively the number of charges increased from the year prior to starting treatment to the year after, the number of some individual types of charges dropped. Most noticeably, the number of charges for illicit drug possession decreased from 70 charges in the year prior to 62 charges in the year after starting treatment. Other types of charges that also decreased in number were prostitution, fraud, violation of probation, and trespassing.
What about retention in the study?
While most participants were only in the study for less than 1 month (137, 62%), 46 (21%) remained for 1–3 months, and 37 (17%) participated for more than 3 months.
So, the retention numbers are as follows:
- 62% dropped out by day 30.
- 83% dropped out by day 90.
The abstract said that “Ten of the 37 [retained for a full year] (27%) never relapsed after their longest period of abstinence from heroin. ” I’m not sure what “after their longest period of abstinence from heroin” means but 10 subjects is 4.5% of the 220 subjects.
The study also attempts to measure some quality of life outcomes, BUT they only report on the 13% who were retained for a year.
- extremely poor retention,
- high relapse rates, and
- reports of quality of life improvements are limited to the 13% retained for a year.
What did the researcher conclude from these findings?
Overall, Suboxone is an effective treatment method for heroin addiction and is a viable outpatient therapy option.
Next time you hear someone assert that drugs like buprenorphine are the most effective treatment, keep in mind that studies like this are part of the evidence-based used to support this position.