Time-limited buprenorphine replacement therapy for opioid dependence: 2-year follow-up outcomes in relation to programme completion and current agonist therapy status

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Abstract
Programme completion is predictive of post‐treatment abstinence and other improvements in persons with opioid dependence, while continued agonist treatment is associated with better outcomes than no agonist treatment. This study aimed to assess relationships between follow‐up outcomes of a 9‐month buprenorphine programme, completion and current agonist therapy status. Sixty‐eight of 75 opioid‐dependent former participants were assessed at study entry and 24 months thereafter. Outcome measures were opioid abstinence, substance use and psychosocial performance. Group comparisons were made between buprenorphine programme completers (n = 38) and non‐completers (n = 30), and between participants who were currently in agonist therapy (n = 37) and those who were not. Performance at follow‐up was compared to that at study entry. Nine people were abstinent from all opioids at follow‐up. Completers and non‐completers were similar in follow‐up performance and patterns of change, while participants' current agonist therapy status was related to both substance use and psychosocial outcomes. Reductions in street opioid use and injecting were seen regardless of completion and agonist therapy status. Retaining patients in agonist replacement therapy over time is more likely than completion of a time‐limited programme to influence long‐term outcomes. Time‐limited buprenorphine replacement therapy appears to be inappropriate for persons with opioid dependence