Recovery From Opioid Use Disorder (OUD) After Monthly Long-acting Buprenorphine Treatment: 12-Month Longitudinal Outcomes From RECOVER, an Observational Study

Abstract

Objectives: While evidence has mounted regarding the short-term effectiveness of pharmacotherapy for opioid use disorder (OUD), little is known about longer-term psychosocial, economic, and health outcomes. We report herein 12-month outcomes for an observational study enrolling participants who had previously taken part in a long-acting buprenorphine subcutaneous injection (BUP-XR) trial for moderate to severe OUD. Methods: The RECOVER (Remission from Chronic Opioid Use: Studying Environmental and SocioEconomic Factors on Recovery; NCT03604861) study enrolled participants from 35 US community-based sites. Self-reported sustained opioid abstinence over 12 months and self-reported past-week abstinence at 3-, 6-, 9-, and 12-month visits were assessed. Multiple regression models assessed the association of BUP-XR duration with abstinence, controlling for potential confounders. Withdrawal, pain, health-related quality of life, depression, and employment at RECOVER baseline and 12-month visits were also compared to values collected before treatment in the BUP-XR trial. Results: Of 533 RECOVER participants, 425 completed the 12-month visit (average age 42 years; 66% male); 50.8% self-reported sustained 12-month and 68.0% past-week opioid abstinence. In multiple regressions, participants receiving 12-month versus ≤2-month BUP-XR treatment duration had significantly higher likelihood of sustained opioid abstinence (75.3% vs 24.1%; P = 0.001), with similar results for past-week self-reported abstinence over time. During RECOVER, participants had fewer withdrawal symptoms, lower pain, positive health-related quality of life, minimal depression, and higher employment versus pre-trial visit. Conclusions: RECOVER participants reported positive outcomes over the 12-month observational period, including high opioid abstinence and stable or improved humanistic outcomes. These findings provide insights into the long-term impact of pharmacotherapy in OUD recovery.

Differential impacts of COVID-19 across racial-ethnic identities in persons with opioid use disorder

“…Despite persistent outreach efforts to contact potential study participants, only 47% of eligible participants from the parent study participated in this study. While most of the characteristics of participants in our sample were well representative of similar research ( Larochelle et al, 2018 ; Ling et al, 2020 ) (i.e. majority male, majority White, majority high school graduate), other participant characteristics are not entirely representative of the population of persons with OUD as a whole.…”

Real-world evidence for a prescription digital therapeutic to treat opioid use disorder

“…The use in this analysis of a composite self-report and/or UDS measure of abstinence/substance use is consistent with other RWE and observational studies of patients with OUD. Studies by Ling et al 36 and Soeffing et al 37 used self-report/ UDS data; studies by Zhu 38 and Darke 39 used self-reported abstinence data only, and a study by Leonardi et al 40 used UDS data only. Unlike a clinical trial where UDS and/or selfreport are collected for evaluating effectiveness, decisions to collect UDS in real-world clinical practice settings are determined by the care model of a particular addiction facility, by clinicians based on the specific needs and status of individual patients, or by attempts to minimize unnecessary testing.…”

Evidence of long-term real-world reduction in healthcare resource utilization following treatment of opioid use disorder with reSET-O, a novel prescription digital therapeutic

“…As in the previous analysis, a 10% increase in buprenorphine adherence was observed in this new analysis, from 74% to 82%. This finding is significant because it suggests that even in this population with relatively high use of buprenorphine, using the PDT's neurobehavioral treatment led to increased medication use, a key goal of treatment [8].…”