Inegrating Buprenorphine Stabilization Into

an Abstinence Based Treatment Program

The distinictive features of the Kolmac buprenorphine program are:

1. Buprenorphine stabilization is embedded within a 2 month IOP rehabilitation setting

- Continued care once weekly for 1 to 2 years is encouraged after IOP

2. Treatment program is otherwise abstinence based

The Study covered our treatment of 490 patients from January 2003 to April to 2007.  The characteristics of the patients were:

1. Willing to participate in structured rehabilitation program
2. Any pain was manageable without opioids
3. Opioid addicted patients were mixed with non-opioid patients

Compared with the previous treatment approach using naltrexone, the results of using buprenorphine were:

1. Improvement in the ability of patients to participate productively in group sessions
2. Increase in the rate of program completion and participation in continuing care

   - Heroin users improved from 21% to 58%

   - Prescription opioid users improved from 37% to 68%

   - Attended an average of 28 weekly continued care sessions

3. No reduction in program completion rates for non-opioid patients

 Unresolved issues are:

1. How long to stay on buprenorphine
2. Mixed acceptance by 12 step groups
3. Resistance from residential treatment programs for use beyond detoxification

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