Adjunctive Counseling During Brief and Extended Buprenorphine-Naloxone Treatment for Prescription Opioid Dependence

Abstract

Abuse of prescription opioids is a significant public health and policy¹ concern, with increasing rates of nonmedical use,² emergency department visits,³ addiction treatment episodes,⁴ overdose deaths,⁵ and costs⁶ related to these drugs in recent years. Despite the growing prevalence of prescription opioid dependence and the availability and increasing use⁷ of buprenorphine hydrochloride treatment (primarily as buprenorphine hydrochloride–naloxone hydrochloride) in physician offices, most opioid dependence treatment research has been conducted with heroin-dependent patients receiving methadone in specialized opioid dependence treatment programs. It is notable, however, that in 2009, the use of a prescription opioid for nonmedical reasons was 20 times more common than was heroin use.⁸ Moreover, almost 50% more people sought treatment for dependence on prescription opioids than for dependence on heroin.⁸ Thus, studying treatments for individuals dependent on prescription opioids has clear public health importance.