[Opioid Maintenance for Patients in Inpatient Long-Term Rehabilitation Treatment - which Patients Benefit?]

Objective: Patients from opioid maintenance treatment (OMT) may taper off from opioids during rehab treatment. It is investigated whether this option improves treatment outcomes in particular for those patients who are affected by psychiatric or somatic comorbidity, or by social problems.
Methods: Multicenter study with 4 rehab units. Patient characteristics and treatment outcomes were collected retrospectively. There were n = 227 patients who were admitted to treatment while still receiving OMT, and n = 156 who were opioid free.
Results: With regard to regular completion of rehab treatment, an interaction was observed between status at admission and diagnosis of affective, neurotic and anxiety disorders, and between status and previous rehab treatment experience. If admitted in an abstinent status, patients who had never entered rehab, and patients with affective or anxiety disorders showed decreased regular completion rates, while they showed increased completion rates if tapered off during treatment. There was no interaction between initial status and acute life crisis (release from prison, homelessness), somatic diagnoses, or number of stabilizing social factors.
Conclusion: Admission while still receiving opiate maintenance could be helpful for patients with psychiatric comorbidity and for patients who had previously been reluctant to enter rehab treatment.
Competing Interests: Norbert Scherbaum hat für Tätigkeiten in Advisory Boards, Vortragstätigkeit, Erstellung von Manuskripten, Erstellung von Weiterbildungsmaterial Honorare der Firmen AbbVie, Hexal, Janssen-Cielag, Lundbeck, MSD, Medice, Munidpharma, Reckitt-Benckiser/Indivior und Sanofi-Aventis erhalten. Er hat in den letzten 3 Jahren an Medikamentenprüfungen teilgenommen, die von der pharmazeutischen Industrie finanziert wurden. Die übrigen Autoren geben keine möglichen Interessenkonflikte an.
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