Exploring the Impact of Buprenorphine/naloxone (Suboxone) Use to Length of Sobriety After Opioid Detoxification

Abstract

PurposeThe purpose of this descriptive correlational study with retrospective chart review was to explore the relationship between inpatient buprenorphine/naloxone (Suboxone) protocols and discharge prescription practices with LOS at an inpatient western Washington Recovery Center. An approval letter from the organization's Director and IRB approval was obtained. The opioid crisis remains a public health concern. Utilization and access to quality Medication Assisted Treatment (MAT) for detoxification can impact length of sobriety (LOS). Relapse rates remain significant for opioid use disorder (OUD). Providers must consider many factors when prescribing buprenorphine/naloxone (Suboxone) inpatient and at discharge. Protocol and prescription practices play a role in relation to LOS and readmission. The conceptual framework was the John Hopkin's evidence-based practice (EBP) model which promotes an inquiry-based approach using evidence-based practice. MethodsWhat is the relationship between inpatient buprenorphine/naloxone (Suboxone) protocols, discharge prescriptions, and LOS? A convenient medical record sample of 150 patient charts were utilized between January 1, 2020, to December 31, 2021, which included a total of 244 readmissions, resulting in a total of 394 admissions. The sample included male and female adult patients over age 18 years who readmitted within one year after completing prior opioid detoxification treatment. Discharge summary and admission intake forms were utilized. ResultsRisk of relapse within 115 days was significantly higher without buprenorphine/naloxone (Suboxone) at discharged, compared to with (RR 3, CI 1.97-5.17; RR 0.34, CI 0.22-0.58). Buprenorphine/naloxone (Suboxone) prescription increased LOS by 42 days (95% CI, p<.0008). Buprenorphine/naloxone (Suboxone) protocol BID increased LOS significantly compared to other protocol groups. Conclusions: Buprenorphine/naloxone (Suboxone) is a partial opioid agonist, and this study is significant for persons involved in pain management, OUD, and the prescription practices impact LOS. It is unclear if it improves quality of life for patients and decreases opioid cravings. Future research is warranted.