Gvantsa Piralishvili1, David Otiashvili2, Zura Sikharulidze3, George Kamkamidze4, Sabrina Poole5, George E Woody6. 1. Centre for Mental Health and Prevention of Addiction, 21a Kavtaradze str., Tbilisi, GA 0186, USA. Electronic address: gpirali@mail.ru. 2. Addiction Research Center, Alternative Georgia, 14a Nutsubidze Street, Office 2,Tbilisi, GA 0177, USA. Electronic address: dato@altgeorgia.ge. 3. Medical Centre Uranti, Nutsubidze 5 Plateau, Build 2a, Tbilisi, GA 0183, USA. Electronic address: zuras@uranti.ge. 4. Health research Union, Nutsubidze 8, Tbilisi, GA 0177, USA. Electronic address: georgekamkamidze@gmail.com. 5. Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania and Treatment Research Institute, 600 Public Ledger Bldg; 150 South Independence Mall (W) Philadelphia, PA 19106, USA. Electronic address: SPoole@tresearch.org. 6. Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania and Treatment Research Institute, 600 Public Ledger Bldg; 150 South Independence Mall (W) Philadelphia, PA 19106, USA. Electronic address: woody@tresearch.org.
Abstract
AIMS: The aim of this study is to assess the prevalence of non-opioid drug use among opioid-addicted, buprenorphine injecting individuals in Georgia, during and after a 12-week course of buprenorphine-naloxone (Suboxone®) or methadone. METHODS: Randomized controlled trial with daily observed Suboxone® or methadone and weekly counseling, urine tests and timeline followback (TLFB) in weeks 0-12 and 20, and the Addiction Severity Index (ASI) at weeks 0, 4, 8, 12, 20. RESULTS: Of the 80 patients (40/group, 4 women), 68 (85%) completed the 12-weeks of study treatment and 66 (82.5%) completed the 20-week follow-up. At baseline, injecting more than one drug in the last 30 days was reported by 68.4% of patients in the methadone and 72.5% in the Suboxone® groups. Drug use was markedly reduced in both treatment conditions but there were significant differences in the prevalence of specific drugs with more opioid (1.5 vs. 0.2%; p=0.03), less amphetamine (0.2 vs. 2.8%; p<0.001) and less marijuana (1.7 vs. 10.2%; p<0.001) positive urine tests in the methadone vs. Suboxone® groups. At the 20-week follow-up, TLFB results on the 34 that continued methadone or the 3 on Suboxone® showed less opioid (5.6 vs. 27.6%; p<0.001), illicit buprenorphine (2.7 vs. 13.8%; p=0.005), benzodiazepine (13.5 vs. 34.5%; p<0.001), and marijuana (2.8 vs. 20.7%; p<0.001) use than the 29 who did not continue opioid substitution therapy. CONCLUSIONS: Despite small but significant differences in opioid and other drug use, both treatments were highly effective in reducing opioid and non-opioid drug use.
RCT Entities:
AIMS: The aim of this study is to assess the prevalence of non-opioid drug use among opioid-addicted, buprenorphine injecting individuals in Georgia, during and after a 12-week course of buprenorphine-naloxone (Suboxone®) or methadone. METHODS: Randomized controlled trial with daily observed Suboxone® or methadone and weekly counseling, urine tests and timeline followback (TLFB) in weeks 0-12 and 20, and the Addiction Severity Index (ASI) at weeks 0, 4, 8, 12, 20. RESULTS: Of the 80 patients (40/group, 4 women), 68 (85%) completed the 12-weeks of study treatment and 66 (82.5%) completed the 20-week follow-up. At baseline, injecting more than one drug in the last 30 days was reported by 68.4% of patients in the methadone and 72.5% in the Suboxone® groups. Drug use was markedly reduced in both treatment conditions but there were significant differences in the prevalence of specific drugs with more opioid (1.5 vs. 0.2%; p=0.03), less amphetamine (0.2 vs. 2.8%; p<0.001) and less marijuana (1.7 vs. 10.2%; p<0.001) positive urine tests in the methadone vs. Suboxone® groups. At the 20-week follow-up, TLFB results on the 34 that continued methadone or the 3 on Suboxone® showed less opioid (5.6 vs. 27.6%; p<0.001), illicit buprenorphine (2.7 vs. 13.8%; p=0.005), benzodiazepine (13.5 vs. 34.5%; p<0.001), and marijuana (2.8 vs. 20.7%; p<0.001) use than the 29 who did not continue opioid substitution therapy. CONCLUSIONS: Despite small but significant differences in opioid and other drug use, both treatments were highly effective in reducing opioid and non-opioid drug use.
Authors: Christina Korownyk; Danielle Perry; Joey Ton; Michael R Kolber; Scott Garrison; Betsy Thomas; G Michael Allan; Nicolas Dugré; Caitlin R Finley; Rhonda Ting; Peter Ran Yang; Ben Vandermeer; Adrienne J Lindblad Journal: Can Fam Physician Date: 2019-05 Impact factor: 3.275