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Significantly improved outcomes – both in retention and CGI scores - using Long Acting Buprenorphine (LAB-Buvidal) versus treatment as usual for Opioid Dependence in Wales during the Pandemic

Published online by Cambridge University Press:  01 September 2022

J. Melichar ,
L. Pearson ,
E. Richards ,
A. Lindsay  and
R. Greenwood
J. Melichar*
Affiliation:
Cardiff and Vale University Health Board, Community Addiction Unit, Cardiff, United Kingdom Cardiff and Vale University Health Board, Community Drugs And Alcohol Services, Cardiff, United Kingdom
L. Pearson
Affiliation:
Cardiff and Vale University Health Board, Community Drugs And Alcohol Services, Cardiff, United Kingdom
E. Richards
Affiliation:
Cardiff and Vale University Health Board, Community Addiction Unit, Cardiff, United Kingdom
A. Lindsay
Affiliation:
Cardiff and Vale University Health Board, Community Drugs And Alcohol Services, Cardiff, United Kingdom
R. Greenwood
Affiliation:
University Hospitals Bristol and Weston, Research Design Service, Bristol, United Kingdom
*
*Corresponding author.

Abstract

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Introduction

We have been using LAB (Buvidal) in Cardiff after its pandemic use was funded by Welsh Government.

Objectives

We wished to review the benefits of introducing LAB (Buvidal) into treatment during the pandemic.

Methods

This service development review of the first 73 patients treated with LAB (24mg/96mg rapid titration Welsh protocol) was analysed using Kaplan-Meier survival curves.

Results

43 (58%) male, 30 (41%) female. <25years=1, 38 (52%) aged 25-40, 34 (47%) 40-55. Prior to LAB 14% (10 people) using Espranor, 8% (6) Buprenorphine, 28% (20) Methadone. 50% (36) illicit opiates (mainly Heroin). We had continuous data for patients for up to 9 months of LAB. Two stopped for non-discontinuation reasons: One wanted to detox, one died of natural causes (LAB-unrelated). Both were excluded from discontinuation rate analysis. 55 people have data for over a month. Of these, 11 discontinued treatment. 80% remained on LAB for 1 month or more [95%CI 67-90%]. Kaplan-Meier plots showed similar discontinuation rates when comparing different OST programmes or none prior to LAB, and comparing by age, sex and initial illness severity (CGI severity). These rates all far exceeded data for traditional OST. CGI scores dramatically improved, even at one week. By month 2 all scores “much improved” or “very much improved”.

Conclusions

Buvidal (LAB) has 80% retention rates, regardless of underlying prescribed/illicit opioid /demographics. The commonly held belief that those on heroin are further from Recovery than those more stable on OAD may be incorrect. LAB may be a more acceptable and useful first line therapy that other OSTs

Disclosure

Dr Melichar has provided consultancy work, presentations, training and chaired panel discussions for all the companies in this area in the UK and some outside the UK. Recent work includes Althea (UK), Britannia (UK), Camurus (UK and Global), Martindale (U

Keywords

buvidallong actingAddictionbuprenorphine
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S814
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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