Retention and attendance with supervised buprenorphine treatment: a case-note review

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Abstract
Since 2001, the Langton Centre has used supervised administration of buprenorphine in treating heroin dependence, without distinguishing between detoxification and maintenance; most people commencing treatment may remain on buprenorphine indefinitely. The aim of this study was to describe retention in treatment, reasons for leaving, re‐entry and pattern of attendance, and compare retention in practice with results from research trials, using a file review of sequential presentations for buprenorphine treatment. Retention in treatment was 37% at 6 months, the same as in Australian research trials of buprenorphine maintenance (37%); most people dropped‐out without consultation or dose tapering. Repeated episodes of treatment constituted 45% of all episodes; missed scheduled doses were common. Participation in buprenorphine treatment often involves repeated, short episodes and erratic attendance. Measures to improve retention in treatment could improve treatment efficacy.

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