Author: TeeJay
Posted: Sat Aug 04, 2012 10:43 pm
Hey guys it’s me TJ. Had to create another account as I lost the password and it was linked to an old email.
I just wanted to bring up something I read in Dr. J’s latest blog post:
| Quote: |
| There were several studies a few years ago that showed relapse rates of 100% in people treated with Suboxone for less than a year; those findings, it seems to me, put a damper on the idea that buprenorphine could be useful for short-term detox. |
(From his talkzone article "Short Timers")
Dr. J did not cite the studies he was referring to, which is why I’ve brought it up here. I’m quite surprised because it’s not the best academic practice to refer to studies like that without providing citations.
Most people who know me on here are aware that I keep serious tabs on research into relapse rates following treatment options. I cannot recall (by memory) one study that showed complete universal relapse of all participants. One study used an expression like "near universal relapse" while discussing its results, but further research into the actual figures showed approx 8% of participants actually remained clean.
The most interesting thing is that whenever Dr. J’s referred to these studies in the past, not once did he say they showed 100% relapse rates. He’d only go as far as saying "virtually 100%", "approaches 100%" or a "very high rate of relapse". How is it then that all of the sudden these same studies can show 100% universal relapse rates?
| Quote: |
| Likewise, treatment with Suboxone, in my opinion, should be considered a long-term process. People treated for less than a year have a very high rate of relapse. |
| Quote: |
| But the obvious comparisons aside, the simple fact is that short-term use of Suboxone has clearly been shown to be a waste of time—the relapse rate is virtually 100%! |
| Quote: |
| If someone asks ‘how long should I stay on Suboxone?’, I’ll reply that several studies show high relapse rates in people who stay on Suboxone for less than 6 months (fact), that more and more physicians are keeping patients on the medication long-term (medical practice), and that in my opinion, many people are best off staying on the medication for an extended period of time. |
| Quote: |
| I don’t understand the attitude, and I know from my observations that the attitude is dangerous for opioid addicts, since the relapse rate in people who stop buprenorphine approaches 100% over the long term. |
We all know Dr. J’s opinions on the issue of short term vs long term buprenorphine, maintenance vs abstinence etc, and that he’s heavily in the pro Suboxone camp, which is why I think it’s fair to question this statement. He’s suggesting that there are at least two (ie several) studies showing 100% relapse rates, without providing citation. I’ve questioned his misleading representations of these results in the past. Using an expression like "approaches 100%" doesn’t sound hopeful at all, but the reality is even the most successful medical treatment of a progressive illness has negative results approaching 100%, as people can only be recorded relapsing or dropping out, not returning.
It’d be nice if someone could help me find these studies, or Dr. J could clarify this himself.
Thanks.