Tag Archives: BMN673

Background Prescribing benzodiazepines during buprenorphine treatment is definitely a topic of

Background Prescribing benzodiazepines during buprenorphine treatment is definitely a topic of active conversation. of an ED check out related to overdose or accidental injury during treatment. Results The 12-month treatment retention rate for the sample (= 328) was 40%. Neither benzodiazepine misuse history nor benzodiazepine prescription was associated with treatment retention or illicit opioid use. Poisson regressions of ED appointments during buprenorphine treatment exposed more ED appointments among those with a benzodiazepine prescription versus those without (< 0.001); benzodiazepine misuse history had no effect. The odds of an accidental injury-related ED check out during treatment were greater among those with a benzodiazepine prescription (OR: 3.7 < 0.01) with an enhanced effect among females (OR: 4.7 < 0.01). Overdose was not associated with benzodiazepine misuse history or prescription. Conclusions We found no effect of benzodiazepine prescriptions on opioid treatment results; however benzodiazepine prescription was associated with more frequent ED appointments and accidental injuries especially among females. When prescribing benzodiazepines during buprenorphine treatment individuals need more education Plxnd1 about accidental injury risk. Alternate treatments for panic should be considered when possible especially among females. = 386) were included in this sequential admission study. Patients were expected to total an intake process including: (1) comprehensive urine toxicology (2) total OBOT nurse care manager assessment and (3) buprenorphine prescription from network physician. We excluded those with an incomplete intake process (= 35 9 To BMN673 enhance external validity we excluded unique populations not generally treated in standard buprenorphine treatment or whose response to benzodiazepines could be atypical (i.e. psychotic disorder (= 2 <1%) pregnancy (= 3 1 and intracranial injury (e.g. traumatic brain injury stroke; = 18 4.6%; Fig. 1). All together we excluded 15% (= 58) from your analysis resulting in 328 individuals included in the analysis. Records for the final sample (= 328) were recorded until the day of OBOT system discharge or until 12 months after intake into OBOT treatment. Fig. 1 Consort diagram. 2.2 Process 2.2 Treatment OBOT consisted of buprenorphine maintenance treatment prescribed by program-affiliated physicians from various medical specialties including internal medicine family medicine and psychiatry. Within this program clinicians urged brief inpatient detoxification before starting buprenorphine maintenance for individuals with co-occurring compound dependence or significant medical problems; however detoxification was not required when opioid dependence was the only substance use disorder BMN673 present. Standard treatment consisted of buprenorphine initiation during a half-day in-office induction. All buprenorphine BMN673 prescriptions with this study were buprenorphine/naloxone co-formulation sublingual tablets. Within this abstinence-focused system individuals typically participated in rigorous outpatient programming during the 1st two weeks of treatment and in response to compound use lapses. The program also required individuals to step down into weekly relapse prevention organizations unless psychiatric needs precluded participation. The program also offered individual therapy and psychopharmacology based on psychiatric need. When an anxiety disorder diagnosis was made by an in-network physician recommending a benzodiazepine prescription the medical director a board-certified habit psychiatrist reviewed the case before granting system authorization. Benzodiazepine prescriptions from out-of-network physicians were not authorized. 2.2 Urine toxicology Nurse care managers conducted urine toxicology at intake and then twice weekly during the 1st month. Weekly urine toxicology was expected for the 1st six months of treatment. If individuals were clinically stable then the system BMN673 required at least regular monthly urine screening for the remainder of the year. If abstinence were violated urine screening frequency improved. Urine toxicology generally used enzyme-mediated immunoassay techniques (Beckman Coulter Fullerton CA) but quick chromatographic immunoassays.