Inpatient withdrawal treatment (detoxification) is common in opioid dependence, although dropout against medical advice often limits its outcome. This study aimed to assess baseline predictors of dropout from inpatient opioid detoxification with buprenorphine, including age, gender, current substance use, and type of postdetoxification planning. A retrospective hospital chart review was carried out for inpatient standard opioid detoxifications using buprenorphine taper, in a detoxification ward in Malm？, Sweden . Thirty-four percent of patients dropped out against medical advice. In multivariate logistic regression, dropout was significantly associated with younger age (OR 0.93 [0.89–0.97]) and negatively predicted by inpatient postdetoxification plan (OR 0.41 [0.18–0.94]), thus favouring an inpatient plan as opposed to outpatient treatment while residing at home. Dropout was unrelated to baseline urine toxicology. In opioid detoxification, patients may benefit from a higher degree of postdetoxification planning, including transition to residential treatment, in order to increase the likelihood of a successful detoxification and treatment entry. Young opioid-dependent patients may need particular attention in the planning of detoxification. 1. Introduction Withdrawal treatment (often referred to as detoxification) is a common treatment practice in heroin-dependent patients attempting to quit heroin use and in order to facilitate entry into psychosocial treatment. Intuitively, retention during inpatient detoxification is likely to be of great value in order to initiate and succeed in subsequent treatment [1]. The premature termination of heroin detoxification is common [2], and high rates of relapse into heroin abuse are seen in patients who fail to enter other treatment after detoxification [3]. Buprenorphine is common as medication in opioid withdrawal and has demonstrated good efficacy in such treatment [4–7]. Typically, withdrawal symptoms occurring during detoxification with buprenorphine have been described to be mild [8]. In addition to a withdrawal medication against specific opioid withdrawal symptoms, a limited amount of previous research has evaluated the role of potential risk factors of dropout from detoxification. The abuse of nonopioid drugs prior to admission, including cocaine, has been suggested as a risk factor for dropout from heroin detoxification [8, 9]. Also, apart from the role of withdrawal medication in the prediction of outcome, early data have suggested that completers of detoxification may have a more severe psychological
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