Starting Buprenorphine therapy. Challenges and difficulties

Background: Buprenorphine was first introduced in Albania in 2014. Since then, the number of patients that are in treatment with Buprenorphine for their addiction, is not increased much.

Methods:This is a prospective study, which is conducted from 2015 to 2020 at University Hospital 'Mother Teresa' in Tirana. 156 patients with opioid use disorder were enrolled in this study, aged > 18 years old, willing to start this treatment and in a good social status.

Results:156 patients started sublingual buprenorphine during this period. From these, 87 patients after detoxification from heroin abuse, started buprenorphine and 69 patients switched the treatment from methadone to buprenorphine. Initial dosage was from 4-8 mg/day, which was increased daily. Maximum dosage was 32 mg/day, but the common maintenance dosage was between 12-24 mg/day. From the first group, 69 patients relapsed, or switched to methadone. From the second group, only 9 stayed on buprenorphine treatment. Most common reasons of discontinuing buprenorphine were, high price, side effects and difficulties to obtain. From patients remaining in treatment, buprenorphine dosage was reduced gradually and actual dosage they are taking is 2 mg every 2-3 days.

Conclusion: Although, a considerable number of patients, referred some possible side effects, none of them discontinued the treatment due to these reasons. High price and difficulties in finding and bying it were the most common reasons, patients discontinued the treatment and relapsed to heroin use.