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Using Behavioral Economics to Predict Opioid Use During Prescription Opioid Dependence Treatment.

Drug and Alcohol Dependence 2015;148:62-68. [doi: 10.1016/j.drugalcdep.2014.12.018]

Matthew J. Worley, PhD, MPH (University of California, Los Angeles, PR Node), Steven J. Shoptaw, PhD (University of California, Los Angeles, PR Node), Warren K. Bickel, PhD (Viginia Tech Carillion Research Institute), Walter Ling, MD (University of California, Los Angeles, PR Node).

Research grounded in behavioral economics has previously linked addictive behavior to disrupted decision-making and reward-processing, but these principles have not been examined in prescription opioid addiction, which is currently a major public health problem. This study examined whether pre-treatment drug reinforcement value predicted opioid use during outpatient treatment of prescription opioid addiction. Secondary analyses examined 353 patients with prescription opioid dependence who received 12 weeks of buprenorphine-naloxone and counseling in a multi-site clinical trial (National Drug Abuse Treatment Clinical Trials Network protocol CTN-0030, "Prescription Opiate Abuse Treatment Study (POATS)"). Baseline measures assessed opioid source and indices of drug reinforcement value, including the total amount and proportion of income spent on drugs. Weekly urine drug screens measured opioid use.

Obtaining opioids from doctors was associated with lower pre-treatment drug spending, while obtaining opioids from dealers/patients was associated with greater spending. Controlling for demographics, opioid use history, and opioid source frequency, patients who spent a greater total amount and a greater proportion of their income on drugs were more likely to use opioids during treatment.

Conclusions: Individual differences in drug reinforcement value, as indicated by pre-treatment allocation of economic resources to drugs, reflects propensity for continued opioid use during treatment among individuals with prescription opioid addiction. Future studies should examine disrupted decision-making and reward-processing in prescription opioid users more directly and test whether reinforcer pathology can be remediated in this population. (Article (Peer-Reviewed), PDF, English, 2014)

Keywords: Behavioral economics | Buprenorphine/naloxone | CTN platform/ancillary study | Prescription-type opiates | Drug and Alcohol Dependence (journal)

Document No: 1116, PMID: 25622776, PMCID: PMC4666717.

Submitted by the CTN Dissemination Librarians, 1/7/2015.

AUTHORS SEARCH LINK
Bickel, Warren K.
Ling, Walter mail
Shoptaw, Steven J. mail
Worley, Matthew J.
PROTOCOLS
NIDA-CTN-0030 www
PARTICIPATING NODES
New England Consortium (Lead) www
Pacific Region (Lead) www
Appalachian Tri-State www
Greater New York www
Ohio Valley www
Pacific Northwest www
Southern Consortium www
Western States www

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 3/2016 -- http://ctndisseminationlibrary.org/display/1116.htm
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