Yih-Ing Hser1, Yuhui Zhu1, Zhe Fei2, Larissa J Mooney1,3, Elizabeth A Evans4, Annemarie Kelleghan5, Abigail Matthews6, Caroline Yoo7, Andrew J Saxon8,9. 1. Department of Psychiatry and Biobehavioral Sciences at the David Geffen School of Medicine, University of California, Los Angeles, USA. 2. Department of Biostatistics, University of California, Los Angeles, USA. 3. Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA. 4. Department of Health Promotion and Policy, University of Massachusetts Amherst, Amherst, MA, USA. 5. Department of Psychology, University of Southern California, Los Angeles, USA. 6. Emmes Corporation, Rockville, MD, USA. 7. Department of Health Policy and Management at the Fielding School of Public Health, University of California, Los Angeles, CA, USA. 8. Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, WA, Seattle, USA. 9. Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.
Abstract
AIMS: To investigate whether reduction in opioid use differs when treated by either buprenorphine-naloxone (BUP) or methadone (MET) among adults with comorbid opioid use disorder (OUD) and mental disorders. DESIGN, SETTING AND PARTICIPANTS: In a randomized controlled trial, adults with OUD were randomized to 24 weeks of either BUP or MET treatment and were followed up in 3-yearly assessments. The present secondary analyses were based on 597 participants who completed all assessments. MEASUREMENTS: The outcome measure was the number of days of using opioids per month during the follow-up period. The Mini-International Neuropsychiatric Interview (MINI) was used to classify participants into three groups: life-time mood disorder (n = 302), life-time mental disorder other than mood disorder (n = 114) and no mental disorder (n = 181). Medication treatment (BUP, MET, no treatment) during the follow-up period was a time-varying predictor. FINDINGS: Based on zero-inflated Poisson (ZIP) mixed regression analysis, it was found that relative to no treatment, opioid use during the follow-up was significantly reduced by BUP [odds ratio (OR) = 0.12, 95% confidence interval (CI) = 0.07-0.21 for any use; risk ratio (RR) = 0.77, 95% CI =0.66-0.89 for days of use] and by MET [OR = 0.33, 95% CI = 0.25-0.45 for any use; RR = 0.78, 95% CI = 0.72-0.84 for days of use]. Relative to MET, BUP was associated with a lower likelihood of any opioid use among participants with mood disorders (OR = 0.52, 95% CI = 0.36-0.74) and for participants without mental disorder (OR = 0.37, 95% CI = 0.21-0.66) and fewer number of days using opioids (RR = 0.37, 95% CI = 0.25-0.56) among participants with other mental disorders. CONCLUSIONS: Among adults with comorbid opioid use disorder and mental disorders, treatment with buprenorphine-naloxone produced greater reductions in opioid use than treatment with methadone.
AIMS: To investigate whether reduction in opioid use differs when treated by either buprenorphine-naloxone (BUP) or methadone (MET) among adults with comorbid opioid use disorder (OUD) and mental disorders. DESIGN, SETTING AND PARTICIPANTS: In a randomized controlled trial, adults with OUD were randomized to 24 weeks of either BUP or MET treatment and were followed up in 3-yearly assessments. The present secondary analyses were based on 597 participants who completed all assessments. MEASUREMENTS: The outcome measure was the number of days of using opioids per month during the follow-up period. The Mini-International Neuropsychiatric Interview (MINI) was used to classify participants into three groups: life-time mood disorder (n = 302), life-time mental disorder other than mood disorder (n = 114) and no mental disorder (n = 181). Medication treatment (BUP, MET, no treatment) during the follow-up period was a time-varying predictor. FINDINGS: Based on zero-inflated Poisson (ZIP) mixed regression analysis, it was found that relative to no treatment, opioid use during the follow-up was significantly reduced by BUP [odds ratio (OR) = 0.12, 95% confidence interval (CI) = 0.07-0.21 for any use; risk ratio (RR) = 0.77, 95% CI =0.66-0.89 for days of use] and by MET [OR = 0.33, 95% CI = 0.25-0.45 for any use; RR = 0.78, 95% CI = 0.72-0.84 for days of use]. Relative to MET, BUP was associated with a lower likelihood of any opioid use among participants with mood disorders (OR = 0.52, 95% CI = 0.36-0.74) and for participants without mental disorder (OR = 0.37, 95% CI = 0.21-0.66) and fewer number of days using opioids (RR = 0.37, 95% CI = 0.25-0.56) among participants with other mental disorders. CONCLUSIONS: Among adults with comorbid opioid use disorder and mental disorders, treatment with buprenorphine-naloxone produced greater reductions in opioid use than treatment with methadone.
Authors: Andrew M Peterson; David P Nau; Joyce A Cramer; Josh Benner; Femida Gwadry-Sridhar; Michael Nichol Journal: Value Health Date: 2007 Jan-Feb Impact factor: 5.725
Authors: Raül Andero; Shaun P Brothers; Tanja Jovanovic; Yen T Chen; Hasib Salah-Uddin; Michael Cameron; Thomas D Bannister; Lynn Almli; Jennifer S Stevens; Bekh Bradley; Elisabeth B Binder; Claes Wahlestedt; Kerry J Ressler Journal: Sci Transl Med Date: 2013-06-05 Impact factor: 17.956
Authors: Margaret L Griffin; Dorian R Dodd; Jennifer S Potter; Lindsay S Rice; William Dickinson; Steven Sparenborg; Roger D Weiss Journal: Am J Drug Alcohol Abuse Date: 2013-11-12 Impact factor: 3.829
Authors: Andrew J Saxon; Walter Ling; Maureen Hillhouse; Christie Thomas; Albert Hasson; Alfonso Ang; Geetha Doraimani; Gudaye Tasissa; Yuliya Lokhnygina; Jeff Leimberger; R Douglas Bruce; John McCarthy; Katharina Wiest; Paul McLaughlin; Richard Bilangi; Allan Cohen; George Woody; Petra Jacobs Journal: Drug Alcohol Depend Date: 2012-08-22 Impact factor: 4.492
Authors: Karen H Seal; Shira Maguen; Daniel Bertenthal; Steven L Batki; Joan Striebel; Murray B Stein; Erin Madden; Thomas C Neylan Journal: J Clin Psychiatry Date: 2016-09 Impact factor: 4.384