Drug and Alcohol Dependence 2013;131(1-2):112-118. [doi: 10.1016/j.drugalcdep.2012.12.010]
Jessica A. Dreifuss, PhD (McLean Hospital, NEC Node), Margaret L. Griffin, PhD (McLean Hospital, NEC Node), Katherine Frost (McLean Hospital, NEC Node), Garrett M. Fitzmaurice, ScD (Harvard School of Public Health, NEC Node), Jennifer Sharpe Potter, PhD (McLean Hospital, NEC Node), David A. Fiellin, MD (Yale University, NEC Node), Jeffrey A. Selzer, MD (Committee for Physician Health, GNY Node), Mary A. Hatch-Maillette, PhD (Alcohol & Drug Abuse Institute, Univ. of Washington, PN Node), Susan C. Sonne, PharmD (Medical University of South Carolina, SC Node), Roger D. Weiss, MD (McLean Hospital, NEC Node).
Prescription opioid dependence is a growing problem, but little research exists on its treatment, including patient characteristics that predict treatment outcome. A secondary analysis from a large, multisite, randomized clinical trial, the National Drug Abuse Treatment Clinical Trials Network (CTN) Prescription Opioid Addiction Treatment Study (POATS, CTN-0030), was undertaken to examine baseline patient characteristics (N=360) associated with success during 12-week buprenorphine/naloxone treatment for prescription opioid dependence. Baseline predictor variables included self-reported demographic and opioid use history information, diagnoses assessed via the Composite International Diagnostic Interview, and historical opioid use and related information from the Pain and Opioid Analgesic Use History. In bivariate analyses, pre-treatment characteristics associated with successful opioid use outcome included older age, past-year or lifetime diagnosis of major depressive disorder, initially obtaining opioids with a medical prescription to relieve pain, having only used opioids by swallowing or sublingual administration, never having used heroin, using an opioid other than extended-release oxycodone most frequently, and no prior opioid dependence treatment. In multivariate analysis, age, lifetime major depressive disorder, having only used opioids by swallowing or sublingual administration, and receiving no prior opioid dependence treatment remained as significant predictors of successful outcome.
Conclusions: This is the first study to examine characteristics associated with treatment outcome in patients dependent exclusively on prescription opioids. Characteristics associated with successful outcome after 12 weeks of buprenorphine/naloxone treatment include some that have been previously found to predict heroin-dependent patients' response to methadone treatment and some specific to prescription opioid-dependent patients receiving buprenorphine-naloxone. It is hoped that knowledge about patient characteristics associated with successful (and unsuccessful) outcome from the current study can be used to help develop more effective treatments for this patient population. (Article (Peer-Reviewed), PDF, English, 2013)
Keywords: Buprenorphine/Naloxone |
CTN platform/ancillary study | Heroin | Opioid dependence | Opioid detoxification |
Outcome predictors | Pharmacological therapy |
Prescription-type opiates | Suboxone | Drug and Alcohol Dependence (journal)
Document No: 941, PMID: 23333292, PMCID: PMC3638044.
Submitted by CTN Dissemination Librarians, 1/24/2013.