Treat alcohol and opioid concurrent withdrawal with buprenorphine: Study

A study of patients admitted to an acute psychiatric unit for concurrent alcohol and opioid withdrawal found that those initiated on buprenorphine within 24 hours had the lowest rate of patient‐directed discharge (PDD), otherwise known as leaving treatment against medical advice. The study highlighted the importance of treating both alcohol use disorder and opioid use disorder concurrently. Despite the well‐established evidence that treating each disorder is effective, there is limited research on concurrently treating both, according to the authors of “Impact of Time to Buprenorphine Initiation on Patient‐Directed Discharge in Concurrent Alcohol and Opioid Withdrawal,” published in the AMERSA publication Substance Use & Addiction Journal online August 14. Treating patients who are going through both alcohol and opioid withdrawal with buprenorphine has benefits for patients and facilities, concluded the research, led by Sean Blaeser, Pharm.D., and colleagues. For the article, the researchers conducted a single‐center retrospective study of patients admitted to the acute psychiatry unit from January 2019 through September 2023 who were at risk for concurrent alcohol and opioid withdrawal. The 322 patients were divided into four cohorts depending on time from admission to buprenorphine administration: 0 to 24 hours (n = 85), 24 to 72 hours (n = 44), greater than 72 hours (n = 16), and those who did not receive buprenorphine (n = 187). Of all admissions meeting inclusion criteria, 43.7% (n = 145) received buprenorphine. Those who did not receive buprenorphine had higher rates of PDD than those who did not (15.5% [n = 29] vs. 6.9% [n = 10]). They also had higher PDD rates than those who initiated buprenorphine between 24 and 72 hours versus 0 to 24 hours of admission (11.4% [n = 5] vs. 5.9% [n = 5]). Absence of buprenorphine initiation also resulted in higher inpatient readmission rates at both 30 (25.1% [n = 47] vs. 11.0% [n = 16]) and 90 days (46% [n = 86] vs. 24.1% [n = 35]).