Journal of Substance Abuse Treatment 2015;48(1):62-69. [doi: 10.1016/j.jsat.2014.07.009]
Jennifer Sharpe Potter, PhD, MPH (McLean Hospital, NEC Node), Jessica A. Dreifuss, PhD (McLean Hospital, NEC Node), Elise N. Marino (University of Texas Health Science Center), Scott E. Provost, MSW, MM (McLean Hospital, NEC Node), Dorian R. Dodd (McLean Hospital, NEC Node), Lindsay S. Rice (McLean Hospital, NEC Node), Garrett M. Fitzmaurice, ScD (McLean Hospital, NEC Node), Margaret L. Griffin, PhD (McLean Hospital, NEC Node), Roger D. Weiss, MD (McLean Hospital, NEC Node).
Despite the high prevalence of prescription opioid dependence in the U.S., little is known about the course of this disorder and the long-term response to treatment. This study examined 18-month post-randomization outcomes of participants in the National Drug Abuse Treatment Clinical Trials Network (CTN) Prescription Opioid Addiction Treatment Study (POATS), a multi-site, randomized controlled trial examining varying durations of buprenorphine-naloxone treatment and different intensities of counseling for prescription opioid dependence. 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.
Conclusions: This 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.b 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. (Article (Peer-Reviewed), PDF, English, 2015)
Keywords: Buprenorphine | Buprenorphine/Naloxone | CTN platform/ancillary study | Heroin | Opioid dependence | Pharmacological therapy | Prescription-type opiates | Suboxone | Taper schedules | Journal of Substance Abuse Treatment (journal)
Document No: 1086, PMID: 25189089, PMCID: PMC4250351.
Submitted by CTN Dissemination Librarians, 8/11/2014.