Treatment of Opioid Dependence: In the HIV Clinic or Out?

Patients treated in the clinic with buprenorphine-naloxone had closer HIV follow-up and better outcomes related to substance abuse than patients referred to methadone maintenance programs.

Many patients seen in HIV clinics have active opioid dependence. These patients are challenging to manage, because their addiction and legal issues often interfere with clinic attendance and medication adherence. Methadone maintenance has been demonstrated to improve outcomes in HIV-infected patients, but it requires referral out of the clinic, treatment slots are often unavailable, and there is a societal stigma. One alternative (reviewed in JW AIDS Clin Care Oct 5 2009) is for patients to receive buprenorphine-naloxone (Suboxone) within their HIV clinic.

To compare these two strategies, researchers conducted a randomized trial at the Johns Hopkins HIV clinic, involving 96 patients with active opioid dependence. Those randomized to clinic-b…

Reviewing Author

Mark Eisenberg, MD

Treatment of Opioid Dependence: In the HIV Clinic or Out?

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Reviewing Author