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Opioid Withdrawal and Craving Trajectories Following Buprenorphine Taper: A Latent Class and Growth Mixture Model of Time-to-First Opioid Lapse.

Poster presented at the College on Problems of Drug Dependence (CPDD) annual meeting, San Diego, CA, June 15-20, 2013.

Thomas F. Northrup, PhD (University of Texas, TX Node), Angela L. Stotts, PhD (University of Texas, TX Node), Charles Green, PhD (University of Texas, TX Node), Jennifer Sharpe Potter, PhD, MPH (University of Texas, TX Node), Elise N. Marino (McLean Hospital, NEC Node), Roger D. Weiss, MD (McLean Hospital, NEC Node), Swetha Mulpur (University of Texas, TX Node), N. Robrina Walker, PhD (University of Texas, TX Node), Madhukar H. Trivedi, MD (University of Texas, TX Node).

This study aimed to quantify the relations between craving and withdrawal symptoms and time to first opioid use among prescription opioid (PO) abusers undergoing buprenorphine detoxification. Higher indicators of craving and withdrawal at the outset of the taper were hypothesized to predict earlier user. Data from 653 PO-dependent individuals initiating a 14-day taper from buprenorphine/naloxone, recruited for the National Drug Abuse Treatment Clinical Trials Network protocol CTN-0030, were analyzed using survival analysis to explore time to first use as a function of opioid craving and withdrawal. Participants were collapsed across condition and measurements taken at the start of the taper were used. Participants were followed for 10 weeks after the taper began. PO craving was measured by 3 items on the Visual Analog Scale (VAS; e.g. "How much do you currently crave opiates?") and opioid withdrawal was measured by the Clinical Opiate Withdrawal Scale and 1 item on the VAS. Withdrawal significantly predicted time to first use, such that each withdrawal unit increase led to a 1.0% decrease in time to first use. Craving items significantly predicted time to first use. Each unit increase on the craving item response scales was associated with a 1.7% to 1.9% decrease in time to first use, depending on the item. Further analyses revealed differences among individuals who terminated study involvement after the first taper and those willing to take part in a second taper.

Conclusions: Higher reports of withdrawal and craving at the outset of a buprenorphine taper are important clinical indicators of earlier lapse to opioids. Novel therapies to attenuate these effects are needed. (Poster, PDF, English, 2013)

Keywords: Buprenorphine/Naloxone | Clinical Opiate Withdrawal Scale (COWS) | Craving | CTN platform/ancillary study | Opioid dependence | Opioid detoxification | Prescription-type opiates | Relapse | Visual Analog Scale (VAS) | College on Problems of Drug Dependence (CPDD) annual meeting, 2013

Document No: 1000

Submitted by Thomas Northrup, PhD, TX Node, 6/22/2013.


Green, Charles search
Marino, Elise N. search
Mulpur, Swetha search
Northrup, Thomas F. search mail
Potter, Jennifer Sharpe search mail
Stotts, Angela L. search
Trivedi, Madhukar H. search mail
Walker, N. Robrina search mail
Weiss, Roger D. search mail
NIDA-CTN-0030 search www

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Supported by a grant from the National Institute on Drug Abuse to the University of Washington Alcohol and Drug Abuse Institute.
The materials on this site have neither been created nor reviewed by NIDA.
Updated 6/2013 --
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