Outcome of patients who taper off opioid maintenance during in-patient rehabilitation treatment for opiate use disorder. A controlled multicenter study

Background: Little is known about the outcome of patients who are accepted into rehabilitation treatment for opiate users (LRT) while receiving an opioid maintenance drug and who plan to taper off during LRT. Method: Patients from four LRT facilities were included if they entered treatment during a 3-year period while still receiving their maintenance drug (OMT group). For each OMT patient entering LRT, a non-OMT patient from the same facility who had entered treatment immediately before or afterwards was selected as control. Analysis included standardized clinical documentation of patient characteristics, treatment process, and treatment outcome. Results: The OMT group (n=227) was similar to the control group (n=156) with regard to sociodemographic and clinical characteristics. A zero dosage was achieved by 37% of OMT patients. LRT was regularly completed by 28% of OMT patients, and by 57% of those OMT patients who had reached zero dosage, compared with 49% of controls. Discussion: Controls represented a preselected group that already had successfully completed detoxification. LRT completion rate therefore appears satisfactory for the OMT group and especially for those who had successfully tapered off opiates during LRT. Opiate taper during LRT is an opportunity to treat patients who are not ready for are preceding detoxification.