Conventional and Unconventional Treatments for Stress among Methadone-Maintained Patients: Treatment Willingness and Perceived Efficacy

Barry, Declan T.; Beitel, Mark; Breuer, Timothy; Cutter, Christopher J.; Savant, Jonathan D.; Schottenfeld, Richard S.; Rounsaville, Bruce J.

doi:10.1111/j.1521-0391.2010.00109.x

Cited by 6 publications

(5 citation statements)

References 29 publications

(15 reference statements)

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“…Participants who met recommended levels of physical activity in the past week had significantly lower levels of depression compared to participants that did not. Complementary to these findings, another study 29 reported that methadone-maintained patients were willing to consider physical exercise as a treatment for stress, with reasonably high perceived efficacy of exercise.…”

Section: Substance Abuse: Research and Treatmentmentioning

confidence: 75%

Aerobic Exercise Interventions for Patients in Opioid Maintenance Treatment: A Systematic Review

et al. 2020

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Background: Opioid maintenance treatment (OMT) is the standard for treatment of opioid use disorder, but some individuals on OMT experience disrupted sleep, heightened sensitivity to pain, and continued relapse to non-medical opioid use. An adjunctive treatment that has potential to address these shortcomings of OMT is aerobic exercise. Objective: The aim of the present review was to identify and evaluate components of aerobic exercise interventions targeting OMT patients. Methods: For this PROSPERO-registered review (ID CRD42020139626), studies were identified via electronic bibliographic databases, funded research ( NIH RePORTER) and clinical trials databases ( ClinicalTrials.gov), and reference sections of relevant manuscripts. Studies that evaluated the effects of an aerobic exercise intervention using a comparison condition or pretest-posttest design in adult OMT patients were included. Results: Of 2971 unique records, three primary studies and one supplemental manuscript comprised the final sample. All studies were randomized trials involving supervised exercise interventions enrolling small samples of middle-aged OMT patients. Exercise interventions included a variety of aerobic and non-aerobic activities (e.g. flexibility exercises), and none controlled the dose of aerobic exercise. Few studies used objective measures of physical activity or cardiorespiratory fitness and there were no significant effects of adjunctive exercise on substance use outcomes, but tests of the latter were likely underpowered. Conclusions: Though early in the accumulation of evidence, interventions targeting aerobic exercise for OMT patients appear feasible, acceptable to patients, and beneficial. Longer-term studies that employ larger samples, include assessments of behavioral and biological mechanisms of change, more rigorous measurement of physical activity, and controlled doses of aerobic activity are warranted.

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Section: Substance Abuse: Research and Treatmentmentioning

confidence: 75%

Aerobic Exercise Interventions for Patients in Opioid Maintenance Treatment: A Systematic Review

et al. 2020

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“…Increased abstinence behavior and decreased cravings have likewise resulted from mindfulness or neurofeedback (biofeedback focused on electroencephalograms, EEG) training in substance abuse treatment (Kevin W Chen et al, 2013; Goldberg et al, 2014; Ross, 2013; Stasiewicz et al, 2013), including opioid addiction (Dehghani-Arani, Rostami, & Nadali, 2013). Higher anxiety or distress has recently been found to increase willingness and perceived treatment efficacy for group stress reduction therapy in MMT (Barry et al, 2011), thus increasing feasibility of incorporating this training into existing intensive outpatient programs. The ASI drug and psychological composite scores with identification of abnormal salivary CORT could be used as routine admission screening tools to identify individuals susceptible to premature discontinuation and stratify treatment interventions in MMT Assessing patient engagement and compliance again at three months may enable determination of interventional efficacy and predict ongoing retention or relapse-risk.…”

Section: Discussionmentioning

confidence: 99%

Psychological and physiological stress negatively impacts early engagement and retention of opioid-dependent individuals on methadone maintenance

Jaremko

Sterling

Bockstaele

2015

Journal of Substance Abuse Treatment

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The present study investigated whether psychological and/or physiological measures of stress would impede induction onto methadone maintenance and predict early (<6 months) discontinuation. Compared with controls, opioid-dependent subjects displayed increased distress on the perceived stress scale (PSS) and post-traumatic stress disorder checklist (PCLC); 60% exhibited abnormal cortisol. Addiction severity index (ASI), drug-use, and stress indices explained between 17–37% of the variance in engagement including attendance, opioid abstinence, and methadone stabilization. Participants who discontinued treatment displayed poor engagement, abnormal cortisol, elevated withdrawal symptoms, higher distress, and increased ongoing opioid use versus compliant individuals. Discontinuation was initially related to drug-use severity; however, by 6 months, retention depended primarily upon cortisol abnormalities, which increased an individual’s discontinuation risk by 7.7-fold. These findings support admission screening with the ASI/cortisol for drop out, and stress/drug-use indices for engagement that together may enable clinically-relevant early recognition and interventions for prevention of stress-induced relapse in opioid-dependent populations.

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“…Whereas we previously reported on a) the prevalence of pain and associated substance use and psychiatric correlates, b) prior pain treatment utilization, and c) perceptions of individual psychosocial interventions among the study sample, we did not report on findings related to willingness to use stress-reducing conventional and unconventional group treatments or the perceived efficacy of such interventions (Barry et al, 2009a; Barry et al, 2009b; Barry et al, in press-a). The primary goal of this needs assessment study was to examine treatment willingness and perceived efficacy of nonpharmacological conventional and unconventional group treatments for managing stress.…”

Section: Introductionmentioning

confidence: 70%

Group-Based Strategies for Stress Reduction in Methadone Maintenance Treatment

Barry

Beitel

Breuer

et al. 2011

Journal of Addiction Medicine

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Objectives To assess methadone maintenance treatment (MMT) patients’ willingness to use, and perceived efficacy of, conventional and unconventional group stress reduction treatments Methods A survey, developed by the authors, was administered to 150 MMT patients. Results Levels of treatment willingness and perceived efficacy for both conventional and unconventional treatments were relatively high; however, ratings for conventional interventions were, on average, significantly higher than those for unconventional ones. The highest rated conventional and unconventional treatments in terms of willingness and perceived efficacy were nutrition and spiritual counseling, respectively, while the lowest rated conventional and unconventional group treatments were anger management and visualization training, respectively. White race was a significant predictor of lower willingness to try conventional and unconventional group therapies and lower perceived efficacy of unconventional group treatment, while female sex and older age were significant predictors of higher levels of willingness to try unconventional group treatment. Higher levels of substance use problems were associated with increased willingness to try conventional group treatment. Higher levels of anxiety emerged as a significant independent predictor of treatment willingness and perceived efficacy for both conventional and unconventional group treatments. Conclusions The relatively high levels of treatment willingness and perceived efficacy of conventional and unconventional group stress reduction treatments point to the feasibility of offering these interventions in MMT and suggest that in particular high levels of anxiety are associated with greater treatment willingness and perceived treatment efficacy.

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Conventional and Unconventional Treatments for Stress among Methadone-Maintained Patients: Treatment Willingness and Perceived Efficacy

Cited by 6 publications

References 29 publications

Aerobic Exercise Interventions for Patients in Opioid Maintenance Treatment: A Systematic Review

Aerobic Exercise Interventions for Patients in Opioid Maintenance Treatment: A Systematic Review

Psychological and physiological stress negatively impacts early engagement and retention of opioid-dependent individuals on methadone maintenance

Group-Based Strategies for Stress Reduction in Methadone Maintenance Treatment

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