{Reference Type}: Journal Article
{Title}: Buprenorphine dose induction in non-opioid-tolerant pre-release prisoners.
{Author}: Vocci FJ;Schwartz RP;Wilson ME;Gordon MS;Kinlock TW;Fitzgerald TT;O'Grady KE;Jaffe JH;
{Journal}: Drug Alcohol Depend
{Volume}: 156
{Issue}: 0
{Year}: Nov 2015 1
{Factor}: 4.852
{DOI}: 10.1016/j.drugalcdep.2015.09.001
{Abstract}: <B>BACKGROUND: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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).<BR><B>CONCLUSIONS: </B>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.