Short-term outcomes after brief ambulatory opioid detoxification with buprenorphine in young heroin users

Aims This study examines the outcomes at 1, 3 and 6 months after a very brief outpatient detoxification with buprenorphine in 18-25-year-old heroin users. Design Prospective follow-up study. Setting Outpatient drug treatment clinic, providing brief detoxification in downtown Baltimore, Maryland. USA. Participants One hundred and twenty-three subjects between 18 and 25 years old; 56% male; 95% Caucasian; seeking detoxification; living in Baltimore City and five surrounding counties. Intervention Detoxification with buprenorphine over 3 days. Follow-up at 1, 3 and 6 months. Measurements Drug use history, the Addiction Severity Index at baseline and follow-up, urine drug screens, evaluation of the detoxification experience. Findings By self-report, 37% of the total sample were not currently using heroin at 1 month, 32% at 3 months and 29%. at 6 months, and 6.7%, 10.1% and 11.8% had an opioid negative urine test at 1, 3 and 6 months, respectively. There was a significant reduction from the baseline in mean Addiction Severity Index drug use composite score, as well as the mean number of days of heroin and cocaine use during past 30 days, that was sustained over the three follow-up points. Engagement in aftercare was generally poor. Conclusions The findings show a reduced frequency and intensity of drug use, suggesting a possible role for brief outpatient detoxification in reducing the severity of dependence for some younger heroin users who may not yet be ready to engage in long-term abstinence-oriented or opioid substitution treatments.