TY - JOUR
T1 - The multi-site prescription opioid addiction treatment study
T2 - 18-month outcomes
AU - Potter, Jennifer Sharpe
AU - Dreifuss, Jessica A.
AU - Marino, Elise N.
AU - Provost, Scott E.
AU - Dodd, Dorian R.
AU - Rice, Lindsay S.
AU - Fitzmaurice, Garrett M.
AU - Griffin, Margaret L.
AU - Weiss, Roger D.
N1 - Funding Information:
Funding for this study was provided by NIDA Clinical Trials Network Grants U10 DA020024 (Trivedi), K23 DA02297 (Potter), U10 DA15831 (Weiss), and K24 DA022288 (Weiss). We gratefully acknowledge the contributions of the staff who contributed to this study, including research assistants and study coordinators from the Division of Alcohol and Drug Abuse at McLean Hospital as well as at each study site and the NIDA Clinical Trials Network (CTN) Data and Statistics Center (DSC1) at the Duke Clinical Research Institute, the support and guidance from the NIDA CTN Clinical Coordinating Center (the EMMES Corporation), and especially the generosity of the study participants.
Publisher Copyright:
© 2014 Elsevier Inc.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Despite the high prevalence of prescription opioid dependence in the U.S., little is known about the course of this disorder and long-term response to treatment. We therefore examined 18-month post-randomization outcomes of participants in the Prescription Opioid Addiction Treatment Study, a multi-site, randomized controlled trial examining varying durations of buprenorphine-naloxone treatment and different intensities of counseling for prescription opioid dependence. Thus the current follow-up study provides a unique contribution to the field by reporting longer-term outcomes of a well-characterized population of treatment-seeking prescription opioid dependent patients. Participants from the treatment trial (N. = 252/653) completed an 18-month follow-up telephone assessment. Multivariable analyses examined associations between participant characteristics and key indicators of month-18 status: opioid abstinence, DSM-IV opioid dependence, and opioid agonist treatment. Overall, participants showed improvement from baseline to month 18: 49.6% were abstinent in the previous 30. days, with only 16.3% opioid-dependent. Some participants, however, had initiated past-year heroin use (n. = 9) or opioid injection (n. = 17). Most participants (65.9%) engaged in substance use disorder treatment during the past year, most commonly opioid agonist therapy (48.8%). Of particular interest in this population, multivariable analysis showed that greater pain severity at baseline was associated with opioid dependence at 18. months. In conclusion, although opioid use outcomes during the treatment trial were poor immediately following a buprenorphine-naloxone taper compared to those during 12. weeks of buprenorphine-naloxone stabilization, opioid use outcomes at 18-month follow-up showed substantial improvement over baseline and were comparable to the rate of successful outcomes during buprenorphine-naloxone stabilization in the treatment trial.
AB - Despite the high prevalence of prescription opioid dependence in the U.S., little is known about the course of this disorder and long-term response to treatment. We therefore examined 18-month post-randomization outcomes of participants in the Prescription Opioid Addiction Treatment Study, a multi-site, randomized controlled trial examining varying durations of buprenorphine-naloxone treatment and different intensities of counseling for prescription opioid dependence. Thus the current follow-up study provides a unique contribution to the field by reporting longer-term outcomes of a well-characterized population of treatment-seeking prescription opioid dependent patients. Participants from the treatment trial (N. = 252/653) completed an 18-month follow-up telephone assessment. Multivariable analyses examined associations between participant characteristics and key indicators of month-18 status: opioid abstinence, DSM-IV opioid dependence, and opioid agonist treatment. Overall, participants showed improvement from baseline to month 18: 49.6% were abstinent in the previous 30. days, with only 16.3% opioid-dependent. Some participants, however, had initiated past-year heroin use (n. = 9) or opioid injection (n. = 17). Most participants (65.9%) engaged in substance use disorder treatment during the past year, most commonly opioid agonist therapy (48.8%). Of particular interest in this population, multivariable analysis showed that greater pain severity at baseline was associated with opioid dependence at 18. months. In conclusion, although opioid use outcomes during the treatment trial were poor immediately following a buprenorphine-naloxone taper compared to those during 12. weeks of buprenorphine-naloxone stabilization, opioid use outcomes at 18-month follow-up showed substantial improvement over baseline and were comparable to the rate of successful outcomes during buprenorphine-naloxone stabilization in the treatment trial.
KW - Buprenorphine
KW - Clinical trial
KW - Follow-up
KW - Prescription opioids
KW - Substance use disorder
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=84922819834&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84922819834&partnerID=8YFLogxK
U2 - 10.1016/j.jsat.2014.07.009
DO - 10.1016/j.jsat.2014.07.009
M3 - Article
C2 - 25189089
AN - SCOPUS:84922819834
SN - 0740-5472
VL - 48
SP - 62
EP - 69
JO - Journal of Substance Abuse Treatment
JF - Journal of Substance Abuse Treatment
IS - 1
ER -