Although there are different approaches to pharmacological interventions and psychosocial therapy in the detoxification setting, overall completion rates of different detoxification regimens are generally low [ 6, 9, 10].
If completion of detoxification is associated with remaining abstinent, use of buprenorphine as an agent of opiate detoxification could be a very important step forward.
There has been relatively little previous controlled research on the impact of treatment setting on the likelihood of successful completion of detoxification.
Although completion of detoxification (detox) and a successful transition from detox to substance use disorder (SUD) treatment and/or mutual-help groups are associated with better SUD outcomes, many patients do not complete detox or do not receive SUD care following detox.
Selecting a data collection point for the primary outcome at completion of detoxification could be seen as a limitation of the study.
At completion of detoxification, by intention to treat analysis we found a higher proportion of people allocated to buprenorphine provided a urine sample negative for opiates (abstinent) compared with those who received dihydrocodeine (21% vs 3%, RR 2.06 CI 1.33 3.21, p = 0.028).
We thought, however, many users would not attend primary care after completion of detoxification simply to provide a urine test, particularly as much of the recruitment was from a homeless population who have been traditionally difficult to engage and retain in treatment services [ 39].
Risk of non-completion of detoxification was reduced if allocated buprenorphine (68% vs 88%, RR 0.58 CI 0.35 0.96, p = 0.065).
Despite this, we found that in 60% of cases self-rated ADHD symptoms remained clinically significant following completion of the detoxification process.
Initially due to pressure on the service a patient could only be initiated onto opiate maintenance if they had failed to become abstinent upon completion of a detoxification regime.
