Predictors of relapse in the early stages of the treatment among inpatients with opioid use disorder: A single-center, prospective cohort study

Gıca, Şakir; Donmez, Zeliha; Ünübol, Başak; İyisoy, Mehmet Sinan; Güleç, Handan

doi:10.5455/pcp.20200302044600

Cited by 2 publications

(10 citation statements)

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“…This scoping review identified 18 studies (Figure 1) evaluating important health outcomes among patients with OUD and ADHD within addiction treatment programs. 6,9,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] The sample size of the included studies ranged from 12 to 81 752 patients. 6,9,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] The follow-up period of longitudinal studies ranged from 12 weeks to 30 years.…”

Section: Resultsmentioning

confidence: 99%

“…6,9,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] The sample size of the included studies ranged from 12 to 81 752 patients. 6,9,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] The follow-up period of longitudinal studies ranged from 12 weeks to 30 years. [24][25][26][27][28][29][30][31][32][33][34]38,39 Included in this review were 1 placebo-controlled trial, 24 5 prospective observational studies, 25,…”

Section: Resultsmentioning

confidence: 99%

“…6,9,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] The follow-up period of longitudinal studies ranged from 12 weeks to 30 years. [24][25][26][27][28][29][30][31][32][33][34]38,39 Included in this review were 1 placebo-controlled trial, 24 5 prospective observational studies, 25,26,28,29,39 7 retrospective observational studies, 27,[30][31][32][33][34]38 and 5 cross-sectional studies. 6,9,[35][36][37] Measures used to diagnose patients with ADHD or to identify patients with current ADHD symptoms included clinical interviews that were structured or semistructured,…”

Section: Resultsmentioning

confidence: 99%

“…31,32 It is also unclear how ADHD severity changed over the course of clinic participation. Furthermore, in the study by Maremmani et al, 32 the presence of a large difference in cumulative survival probability between individuals with (0.30) and without ADHD (0.71) with the lack of statistical Count and percent of patients retained for <2 years No ADHD: 150 (72%) ADHD: 57 (28%) Gica et al 39 Total: 100 ADHD: not reported ASRS Logistic regression examining relationship between ADHD scale subscores with experiencing an early relapse Attention deficit score*: Exp(B) 95% CI: 0.85 (0.73-0.98) Impulsivity score*: Exp(B) 95% CI: 1.24 (1.01-1.51) Abbreviations: ADHD, attention deficit/hyperactivity disorder; aHR, adjusted hazard ratio; ASRS, Adult ADHD Self-Report Scale; CD, cocaine disorder; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders fourth edition; MAT, medication-assisted treatment; MMT, methadone maintenance treatment; THD, take home dose. *Statistically significant as noted by a P value <0.05.…”

Section: Effect Of Oud Treatment On Oud-related Outcomesmentioning

confidence: 99%

“…7,9,41 Additionally, patients with ADHD receiving OMT were more likely to use other substances in addition to opioids, misuse their prescribed OMT, and experience worse outcomes compared to those without ADHD when receiving treatment for OUD. 6,39 Therefore, the screening for and effective treatment of ADHD are important aspects of an appropriate OUD treatment.…”

Section: Comments On the Treatment Of Adhdmentioning

confidence: 99%

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Gaps in Evidence-based Treatment of Concurrent Attention Deficit Hyperactivity Disorder and Opioid Use Disorder: A Scoping Review

2022

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Objectives: To describe the effectiveness of medications for the treatment of opioid use disorder (OUD) and attention deficit/hyperactivity disorder (ADHD). Data Sources: Literature search of PubMed, Embase, Web of Science, CINAHL, Medline, PsycINFO, and Google Scholar was performed for studies published from inception to October 25, 2022. Study Selection and Data Extraction: Studies were included if patients were diagnosed with OUD and ADHD and had pharmacotherapy for either condition. Abstracts, commentaries, reviews, case reports, case series, non-English articles, and animal studies were omitted. Data Synthesis: This review found 18 studies. Treatment of ADHD was evaluated for impact on ADHD and OUD outcomes, while treatment of OUD was evaluated for OUD-related outcomes. Outcomes assessed included markers for symptom intensity, adherence, and treatment failure. While results were mixed, treatment of ADHD was largely associated with improvements in ADHD severity and retention in OUD treatment programs. ADHD severity was associated with higher rates of illicit substance abuse and worse OUD-related outcomes. It could not be determined which medications for treatment of OUD should be prioritized. Relevance to Patient Care and Clinical Practice: This review summarized key findings from studies that treated ADHD or OUD among dually diagnosed patients and highlighted methodological considerations for future research. Conclusions: Treatment of ADHD is warranted among patients with OUD and ADHD to improve retention in OUD treatment programs and reduce illicit substance abuse. Pharmacotherapy for the treatment of ADHD or OUD should continue to be determined based on patients' characteristics and the capabilities of the treatment program.

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