INTRODUCTION: The relevance of tobacco use in opioid addiction (OA) has generated a demand for available and more effective interventions. Thus, further analysis of less explored nicotine-opioid clinical interactions is warranted. METHODS: A post-hoc analysis of OA participants in a double-blind, randomized very low dose naltrexone (VLNTX) inpatient detoxification trial evaluated measures of opioid withdrawal and tobacco use. Intreatment smokers were compared with nonsmokers, or smokers who were not allowed to smoke. RESULTS:A total of 141 (81%) of 174 OA participants were smokers, all nicotine-dependent. Inpatient smoking was a predictor of opioid withdrawal discomfort. Intreatment smokers (n = 96) showed significantly higher opioid craving (F = 3.7, p < .001) and lower detoxification completion rate (χ(2) = 7.9, p < .02) compared with smokers who were not allowed to smoke (n = 45) or nonsmokers (n = 33). Smoking during treatment was associated with more elevated cigarette craving during detoxification (F = 4.1, p < .001) and a higher number of cigarettes smoked at follow-up (F = 3.6, p < .02). Among intreatment smokers, VLNTX addition to methadone taper was effective in easing opioid withdrawal and craving more than other treatments, whereas the combination VLNTX-clonidine was associated with significantly reduced cigarette craving and smoking during detoxification. CONCLUSIONS: Failure to address tobacco use may negatively affect pharmacologically managed opioid discontinuation. Opioid detoxification may offer a window of opportunity to expand smoking cessation treatment, hence improving OA outcomes. The observed effects support testing of VLNTX-clonidine in smoking cessation trials among individuals with or without substance abuse.
RCT Entities:
INTRODUCTION: The relevance of tobacco use in opioid addiction (OA) has generated a demand for available and more effective interventions. Thus, further analysis of less explored nicotine-opioid clinical interactions is warranted. METHODS: A post-hoc analysis of OA participants in a double-blind, randomized very low dose naltrexone (VLNTX) inpatient detoxification trial evaluated measures of opioid withdrawal and tobacco use. Intreatment smokers were compared with nonsmokers, or smokers who were not allowed to smoke. RESULTS: A total of 141 (81%) of 174 OA participants were smokers, all nicotine-dependent. Inpatient smoking was a predictor of opioid withdrawal discomfort. Intreatment smokers (n = 96) showed significantly higher opioid craving (F = 3.7, p < .001) and lower detoxification completion rate (χ(2) = 7.9, p < .02) compared with smokers who were not allowed to smoke (n = 45) or nonsmokers (n = 33). Smoking during treatment was associated with more elevated cigarette craving during detoxification (F = 4.1, p < .001) and a higher number of cigarettes smoked at follow-up (F = 3.6, p < .02). Among intreatment smokers, VLNTX addition to methadone taper was effective in easing opioid withdrawal and craving more than other treatments, whereas the combination VLNTX-clonidine was associated with significantly reduced cigarette craving and smoking during detoxification. CONCLUSIONS: Failure to address tobacco use may negatively affect pharmacologically managed opioid discontinuation. Opioid detoxification may offer a window of opportunity to expand smoking cessation treatment, hence improving OA outcomes. The observed effects support testing of VLNTX-clonidine in smoking cessation trials among individuals with or without substance abuse.
Authors: Sudie E Back; Rebecca L Payne; Amy Herrin Wahlquist; Rickey E Carter; Zachary Stroud; Louise Haynes; Maureen Hillhouse; Kathleen T Brady; Walter Ling Journal: Am J Drug Alcohol Abuse Date: 2011-09 Impact factor: 3.829
Authors: Nicole H Mutschler; Bruce J Stephen; Siew Koon Teoh; Jack H Mendelson; Nancy K Mello Journal: Nicotine Tob Res Date: 2002-05 Impact factor: 4.244
Authors: Paolo Mannelli; Edward Gottheil; James F Peoples; Veronica C Oropeza; Elisabeth J Van Bockstaele Journal: Biol Psychiatry Date: 2004-08-15 Impact factor: 13.382
Authors: Traci R Rieckmann; Nicholas Gideonse; Amanda Risser; Jennifer E DeVoe; Amanda J Abraham Journal: J Behav Health Serv Res Date: 2017-07 Impact factor: 1.505
Authors: R Kathryn McHugh; Victoria R Votaw; Francesca Fulciniti; Hilary S Connery; Margaret L Griffin; Peter M Monti; Roger D Weiss Journal: J Subst Abuse Treat Date: 2016-12-30
Authors: Erin A McClure; Aimee N C Campbell; Martina Pavlicova; Meichen Hu; Theresa Winhusen; Ryan G Vandrey; Lesia M Ruglass; Lirio S Covey; Maxine L Stitzer; Tiffany L Kyle; Edward V Nunes Journal: J Subst Abuse Treat Date: 2014-12-30
Authors: A-L Wang; I Elman; S B Lowen; S J Blady; K G Lynch; J M Hyatt; C P O'Brien; D D Langleben Journal: Transl Psychiatry Date: 2015-03-17 Impact factor: 6.222