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Correlates of Long-Term Opioid Abstinence After Randomization to Methadone Versus Buprenorphine/Naloxone in Multi-Site Trial.

Journal of Neuroimmune Pharmacology 2018 (in press). [doi: 10.1007/s11481-018-9801-x]

Yuhui Zhu (University of California, Los Angeles, PR Node), Elizabeth A. Evans, PhD (University of Massachusetts), Larissa J. Mooney, MD (University of California, Los Angeles, PR Node), Andrew J. Saxon, MD (Veterans Affairs Puget Sound Health Care System, PN Node), Annamarie Kelleghan (University of Southern California), Caroline Yoo (University of California, Los Angeles, PR Node), Yih-Ing Hser, PhD (University of California, Los Angeles, PR Node).

Opioid use disorder (OUD) is a chronic, relapsing condition with severe negative health consequences. Previous studies have reported that 5-year abstinence is a good predictor of reduced likelihoods of relapse, but factors that shape long-term opioid abstinence are poorly understood.

The present study is based on data from a prospective study of 699 adults with OUD who had been randomized to either methadone or buprenorphine/naloxone and who were followed for at least 5 years (CTN-0050, Long Term Follow-Up of START Patients). During the 5 years prior to the participants' last follow-up interview, 232 (33.2%) had achieved 5-year abstinence from heroin. Of those 232, 145 (20.7% of the total) had remained abstinent from both heroin and other opioids (e.g., hydrocodone, oxycodone, other opioid analgesics, excluding methadone or buprenorphine). Compared to non-abstinent individuals, those in both categories of opioid abstinence had lower problem severity in health and social functioning at the final follow-up. Logistic regression results indicated that cocaine users and injection drug users were less likely to achieve 5-year heroin abstinence, whereas Hispanics (vs. whites) and those treated in clinics on the West Coast (vs. East) were less likely to achieve 5-year abstinence from heroin and other opioids. For both abstinence category groups, abstinence was positively associated with older age at first opioid use, lower impulsivity, longer duration of treatment for OUD, and greater social support.

Conclusions: Given the current opioid crisis, this study contributes valuable information by identifying correlates of long-term opioid abstinence that are important for efforts to facilitate stable recovery. Reducing cocaine use and injection drug use and increasing social support and retention in treatment may help maintain long-term abstinence from opioids among individuals treated with agonist pharmacotherapy. (Article (Peer-Reviewed), PDF, English, 2018)

Keywords: Buprenorphine/Naloxone | Cocaine | CTN platform/ancillary study | Heroin | Methadone maintenance | Pharmacological therapy | Prescription-type opiates | Relapse | Suboxone | Journal of Neuroimmune Pharmacology (journal)

Document No: 1331, PMID: 30094695.

Submitted by CTN Dissemination Librarians, 8/16/2018.

 

AUTHORS SEARCH LINK
Evans, Elizabeth A.
Hser, Yih-Ing mail
Kelleghan, Annamarie
Mooney, Larissa J.
Saxon, Andrew J.
Yoo, Caroline
Zhu, Yuhui
PROTOCOLS
NIDA-CTN-0050 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 8/2018 -- http://ctndisseminationlibrary.org/display/1331.htm
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