OBJECTIVES: Dependence on prescription opioids (PO) is a growing problem. Although most research with buprenorphine has focused on heroin-dependent populations, we hypothesize that individuals dependent on PO display characteristics that may predict different outcomes in treatment, particularly in short-term taper procedures in which comorbidities such as pain conditions may complicate taper. METHODS: This secondary data analysis examined differences in outcomes between POusers (n = 90) and heroin users (n = 426) after abuprenorphine taper. Data were collected in a multisite randomized clinical trial conducted by the National Drug Abuse Treatment Clinical Trials Network at 11 study sites across the United States. After a 4-week buprenorphine induction/stabilization phase, 516 opioid-dependent individuals were randomized into 1 of 2 taper lengths (7 vs 28 days) to assess the association between taper length and outcome. The primary outcome was measured by urine drug test for opioids at the end of the taper period. Craving, withdrawal, and buprenorphine dose were also examined. RESULTS: After controlling for baseline demographic and drug use differences between the opioid use groups, results indicate that a higher percentage of the PO group (49%) provided an opioid-free urine drug specimen at the end of taper compared with the heroin group (36%; χ(2)(1) = 6.592, P < 0.010). CONCLUSION: Short-term taper is not recommended as a stand-alone treatment; however, patients may taper from buprenorphine as part of a treatment plan. Despite greater comorbidity, PO users seem to have favorable taper outcomes compared with heroin users. Further studies are required to examine longer-term treatment outcomes.
RCT Entities:
OBJECTIVES: Dependence on prescription opioids (PO) is a growing problem. Although most research with buprenorphine has focused on heroin-dependent populations, we hypothesize that individuals dependent on PO display characteristics that may predict different outcomes in treatment, particularly in short-term taper procedures in which comorbidities such as pain conditions may complicate taper. METHODS: This secondary data analysis examined differences in outcomes between PO users (n = 90) and heroin users (n = 426) after a buprenorphine taper. Data were collected in a multisite randomized clinical trial conducted by the National Drug Abuse Treatment Clinical Trials Network at 11 study sites across the United States. After a 4-week buprenorphine induction/stabilization phase, 516 opioid-dependent individuals were randomized into 1 of 2 taper lengths (7 vs 28 days) to assess the association between taper length and outcome. The primary outcome was measured by urine drug test for opioids at the end of the taper period. Craving, withdrawal, and buprenorphine dose were also examined. RESULTS: After controlling for baseline demographic and drug use differences between the opioid use groups, results indicate that a higher percentage of the PO group (49%) provided an opioid-free urine drug specimen at the end of taper compared with the heroin group (36%; χ(2)(1) = 6.592, P < 0.010). CONCLUSION: Short-term taper is not recommended as a stand-alone treatment; however, patients may taper from buprenorphine as part of a treatment plan. Despite greater comorbidity, PO users seem to have favorable taper outcomes compared with heroin users. Further studies are required to examine longer-term treatment outcomes.
Authors: Roger D Weiss; Jennifer Sharpe Potter; David A Fiellin; Marilyn Byrne; Hilary S Connery; William Dickinson; John Gardin; Margaret L Griffin; Marc N Gourevitch; Deborah L Haller; Albert L Hasson; Zhen Huang; Petra Jacobs; Andrzej S Kosinski; Robert Lindblad; Elinore F McCance-Katz; Scott E Provost; Jeffrey Selzer; Eugene C Somoza; Susan C Sonne; Walter Ling Journal: Arch Gen Psychiatry Date: 2011-11-07
Authors: John S Cacciola; Arthur I Alterman; A Thomas McLellan; Yi-Ting Lin; Kevin G Lynch Journal: Drug Alcohol Depend Date: 2006-10-11 Impact factor: 4.492
Authors: Brent A Moore; David A Fiellin; Declan T Barry; Lynn E Sullivan; Marek C Chawarski; Patrick G O'Connor; Richard S Schottenfeld Journal: J Gen Intern Med Date: 2007-04 Impact factor: 5.128
Authors: Katherine A McDermott; Margaret L Griffin; Hilary S Connery; E Yvette Hilario; David A Fiellin; Garrett M Fitzmaurice; Roger D Weiss Journal: J Clin Psychiatry Date: 2015-02 Impact factor: 4.384
Authors: Roger D Weiss; Jennifer Sharpe Potter; Margaret L Griffin; Scott E Provost; Garrett M Fitzmaurice; Katherine A McDermott; Emily N Srisarajivakul; Dorian R Dodd; Jessica A Dreifuss; R Kathryn McHugh; Kathleen M Carroll Journal: Drug Alcohol Depend Date: 2015-03-06 Impact factor: 4.492
Authors: Maria Sullivan; Adam Bisaga; Martina Pavlicova; C Jean Choi; Kaitlyn Mishlen; Kenneth M Carpenter; Frances R Levin; Elias Dakwar; John J Mariani; Edward V Nunes Journal: Am J Psychiatry Date: 2017-01-10 Impact factor: 18.112
Authors: Kelly E Dunn; Kathryn A Saulsgiver; Mollie E Miller; Paul A Nuzzo; Stacey C Sigmon Journal: Drug Alcohol Depend Date: 2015-03-12 Impact factor: 4.492
Authors: Jennifer Sharpe Potter; Jessica A Dreifuss; Elise N Marino; Scott E Provost; Dorian R Dodd; Lindsay S Rice; Garrett M Fitzmaurice; Margaret L Griffin; Roger D Weiss Journal: J Subst Abuse Treat Date: 2014-08-02
Authors: Nalini Vadivelu; Alice M Kai; Gopal Kodumudi; Dan Haddad; Vijay Kodumudi; Niketh Kuruvilla; Alan David Kaye; Richard D Urman Journal: Curr Pain Headache Rep Date: 2018-03-19