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Early initiation of buprenorphine treatment for opioid use disorder (compared to referral to treatment only)

Substance Use Disorders: Treatment for Adults
  Literature review updated December 2016.

Studies included in this analysis compared early initiation of buprenorphine treatment to simply referring patients to treatment. The interventions provided temporary, early treatment initiation at a university HIV clinic, an emergency department, a hospital, and a prison. The studies measured subsequent entry into community-based opioid treatment within a short follow-up period.
 
ALL
META-ANALYSIS
CITATIONS

Meta-analysis is a statistical method to combine the results from separate studies on a program, policy, or topic to estimate its effect on an outcome. WSIPP systematically evaluates all credible evaluations we can locate on each topic. The outcomes measured are the program impacts measured in the research literature (for example, impacts on crime or educational attainment). Treatment N represents the total number of individuals or units in the treatment group across the included studies.

An effect size (ES) is a standard metric that summarizes the degree to which a program or policy affects a measured outcome. If the effect size is positive, the outcome increases. If the effect size is negative, the outcome decreases. See Estimating Program Effects Using Effect Sizes for additional information on how we estimate effect sizes.

The effect size may be adjusted from the unadjusted effect size estimated in the meta-analysis. Historically, WSIPP adjusted effect sizes to some programs based on the methodological characteristics of the study. For programs reviewed in 2024 or later, we do not make additional adjustments, and we use the unadjusted effect size whenever we run a benefit-cost analysis.

Research shows the magnitude of effects may change over time. For those effect sizes, we estimate outcome-based adjustments, which we apply between the first time ES is estimated and the second time ES is estimated. More details about these adjustments can be found in our Technical Documentation.

Meta-Analysis of Program Effects
Outcomes measured No. of effect sizes Treatment N Effect sizes (ES) and standard errors (SE) Unadjusted effect size (random effects model)
ES SE Age ES p-value
Engagement/Retention
Retention and engagement in treatment or care.
 38 4 336 0.994 0.292 38 0.994 0.001

Citations Used in the Meta-Analysis

D'Onofrio, G., Pantalon, M.V., Owens, P.H., Bernstein, S.L., O'Connor, P.G., Fiellin, D.A., . . . & Fiellin, D.A. (2015). Emergency department-initiated buprenorphine/naloxone treatment for opioid dependence: A randomized clinical trial. JAMA, 313(16), 1636-1644.

Gordon, M.S., Kinlock, T.W., Schwartz, R.P., Fitzgerald, T.T., O'Grady, K.E., & Vocci, F.J. (2014). A randomized controlled trial of prison-initiated buprenorphine: prison outcomes and community treatment entry. Drug and Alcohol Dependence, 142, 33-40.

Liebschutz, J.M., Crooks, D., Herman, D., Anderson, B., Tsui, J., Meshesha, L.Z., . . . Stein, M. (2014). Buprenorphine treatment for hospitalized, opioid-dependent patients: a randomized clinical trial. Jama Internal Medicine, 174(8), 1369-76.

Lucas, G.M., Chaudhry, A., Hsu, J., Woodson, T., Lau, B., Olsen, Y., . . . Moore, R.D. (2010). Clinic-based treatment of opioid-dependent HIV-infected patients versus referral to an opioid treatment program: A randomized trial. Annals of Internal Medicine, 152(11), 704-711.