Opioid Addicted Buprenorphine Injectors: Drug Use During and After 12-Weeks of Buprenorphine–Naloxone or Methadone in the Republic of Georgia

• Assessed the prevalence of drug use in a 12 week study with Suboxone or methadone.
• 70% of patients reported injecting more than one drug past 30 days at baseline.
• 85% of patients completed the 12-week treatment and 82.5% the 20-week follow-up.
• Both treatments were highly effective in reducing opioid and non-opioid drug use.

AimsThe aim of this study is to assess the prevalence of non-opioid drug use among opioid-addicted, buprenorphine injecting individuals in Georgia, during and after a 12-week course of buprenorphine–naloxone (Suboxone®) or methadone.MethodsRandomized controlled trial with daily observed Suboxone® or methadone and weekly counseling, urine tests and timeline followback (TLFB) in weeks 0–12 and 20, and the Addiction Severity Index (ASI) at weeks 0, 4, 8, 12, 20.ResultsOf the 80 patients (40/group, 4 women), 68 (85%) completed the 12-weeks of study treatment and 66 (82.5%) completed the 20-week follow-up. At baseline, injecting more than one drug in the last 30 days was reported by 68.4% of patients in the methadone and 72.5% in the Suboxone® groups. Drug use was markedly reduced in both treatment conditions but there were significant differences in the prevalence of specific drugs with more opioid (1.5 vs. 0.2%; p = 0.03), less amphetamine (0.2 vs. 2.8%; p < 0.001) and less marijuana (1.7 vs. 10.2%; p < 0.001) positive urine tests in the methadone vs. Suboxone® groups.At the 20-week follow-up, TLFB results on the 34 that continued methadone or the 3 on Suboxone® showed less opioid (5.6 vs. 27.6%; p < 0.001), illicit buprenorphine (2.7 vs. 13.8%; p = 0.005), benzodiazepine (13.5 vs. 34.5%; p < 0.001), and marijuana (2.8 vs. 20.7%; p < 0.001) use than the 29 who did not continue opioid substitution therapy.ConclusionsDespite small but significant differences in opioid and other drug use, both treatments were highly effective in reducing opioid and non-opioid drug use.