Buprenorphine dose induction in non-opioid-tolerant pre-release prisoners
Buprenorphine dose induction in non-opioid-tolerant pre-release prisoners
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DOI：
10.1016/j.drugalcdep.2015.09.001
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发表时间：
2015-11-01
影响因子：
4.2
通讯作者：
Jaffe, Jerome H.
中科院分区：
文献类型：
--
作者：
Vocci, Frank J.;Schwartz, Robert P.;Jaffe, Jerome H.
背景：在先前报道的一项随机对照试验中，前阿片类药物依赖的囚犯在监狱中接受丁丙诺啡/纳洛酮（以下称为丁丙诺啡）的诱导时，比在监狱中接受不使用丁丙诺啡的咨询时更有可能进入社区药物滥用治疗（47.5% vs. 33.7%, p = 0.012） （Gordon et al., 2014）。在本通讯中，我们报告了诱导时间表的结果和在释放前囚犯中诱导丁丙诺啡的不良事件概况。方法：本文对104名在监狱中随机接受丁丙诺啡治疗的成年参与者的剂量诱导程序、建议剂量与每周实际剂量的比较以及报告的副作用进行了研究。使用广义估计方程分析自我报告的副作用，以确定副作用随时间的变化。结果：研究参与者以比诱导计划更快的速度诱导到丁丙诺啡。在104名接受丁丙诺啡治疗的人中（72名男性，32名女性），64名（37名男性，27名女性）在出狱后仍在服药。9名参与者（8.6%）因阿片类药物副作用停用丁丙诺啡。在研究的监狱阶段没有报告严重的不良事件。便秘是最常见的症状（69%）。结论：我们的研究结果表明，对于非阿片类药物耐受的成年人，丁丙诺啡应以较低的个体化剂量开始，而不是通常用于积极使用阿片类药物的成年人，并且非阿片类药物耐受的预释放囚犯可以在释放前成功诱导到治疗剂量。2015爱思唯尔爱尔兰有限公司版权所有。
Background: In a previously reported randomized controlled trial, formerly opioid-dependent prisoners were more likely to enter community drug abuse treatment when they were inducted in prison onto buprenorphine/naloxone (hereafter called buprenorphine) than when they received counseling without buprenorphine in prison (47.5% vs. 33.7%, p = 0.012) (Gordon et al., 2014). In this communication we report on the results of the induction schedule and the adverse event profile seen in pre-release prisoners inducted onto buprenorphine.Method: This paper examines the dose induction procedure, a comparison of the proposed versus actual doses given per week, and side effects reported for 104 adult participants who were randomized to buprenorphine treatment in prison. Self-reported side effects were analyzed using generalized estimated equations to determine changes over time in side effects.Results: Study participants were inducted onto buprenorphine at a rate faster than the induction schedule. Of the 104 (72 males, 32 females) buprenorphine recipients, 64 (37 males, 27 females) remained on medication at release from prison. Nine participants (8.6%) discontinued buprenorphine because of unpleasant opioid side effects. There were no serious adverse events reported during the in-prison phase of the study. Constipation was the most frequent symptom reported (69 percent).Conclusion: Our findings suggest that buprenorphine administered to non-opioid-tolerant adults should be started at a lower, individualized dose than customarily used for adults actively using opioids, and that non-opioid-tolerant pre-release prisoners can be successfully inducted onto therapeutic doses prior to release. (C) 2015 Elsevier Ireland Ltd. All rights reserved.