The Baltimore Buprenorphine Initiative: A Comparison of Treatment Modalities for Addressing Heroin Addiction in an Urban-Based Community

Friday, 26 July 2013: 10:55 AM

Lyn Stankiewicz Murphy, PhD, MBA, MS, RN
Department of Organizational Systems and Adult Health, University of Maryland, Baltimore, Baltimore, MD
Marla T. Oros, MS, RN
The Mosaic Group, Baltimore, MD

Learning Objective 1: Compare and contrast demographics factors among treatment modalities for heroin addiction.

Learning Objective 2: Appraise best practices for treatment modalities among heroin addiction.

Purpose: Adequate drug treatment for substance users continues to be a challenge for most United States (US) cities. In order to address heroin addiction in Baltimore, the Baltimore Buprenorphine Initiative (BBI) was implemented as a joint project to promote individualized, patient-centered buprenorphine therapy in conjunction with behavioral treatment to accelerate recovery from opioid addiction. 

Methods: The BBI sample consisted of 1,039 subjects treated with buprenorphine and counseling between January 1, 2008 and June 1, 2009. Demographic and outcome variables were evaluated against two comparison groups of 8,692 patients receiving methadone treatment and 6,664 patients receiving intensive outpatient or standard outpatient (IOP-OP) treatment. Analytical methods were utilized to assess each of the three treatment groups in order to measure the simultaneous impact of a set of variables on an individual's LOS.

Results: The BBI sample consisted of 1,039 subjects treated between January 1, 2008 and June 1, 2009. Using analysis of variance, statistically significant differences among the groups were identified in three areas: age, lapse of time until admission to treatment, and length of stay in treatment. Controlling for age, gender, education, race, income, and employment, the following independent variables were used to predict LOS: lapse of time to admission, ASI scores, number of addictions, frequency of addictions, and group membership (BBI, methadone, or IOP).  Demographic characteristics accounted for 15.8 % of the variance (R2 = 0.158) with the overall model explaining 42.6% of the variance surrounding the dependent variable LOS (R2=0.426). The model was statistically significant (F=223.51, df 18, 5413, p<0.001).

Conclusion: The findings of this study have practical implications for the design and implementation of heroin addiction programs. The research indicates that focusing on these specific predictive variables early in the program design phase could increase recovery success rates as measured by length of stay.