Recovery from opioid use disorder: A 4-year post-clinical trial outcomes study

Craft, William H; Tegge, Allison N.; Keith, Diana R.; Shin, Hwasoo; Williams, Jacob; Stein, Jeffrey S.; Chilcoat, Howard D.; Moigne, Anne Le; DeVeaugh‐Geiss, Angela; Bickel, Warren K.

doi:10.1016/j.drugalcdep.2022.109389

Cited by 4 publications

(6 citation statements)

References 42 publications

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“…The relationship between opioid dependence or misuse with depression and anxiety has been demonstrated in previous studies 8–15 . Research has shown that a diagnosis of a mental health disorder results in an increased risk of utilization of nonmedical opioids and opioid use disorder 13–15 .…”

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confidence: 82%

“…Research has shown that a diagnosis of a mental health disorder results in an increased risk of utilization of nonmedical opioids and opioid use disorder 13–15 . It has been demonstrated that the existence of a mood or anxiety disorder increases the risk of opioid use or misuse, but there is also a suggestion that opioid use could also increase the risk of developing mood and anxiety disorders 9,10,12,14 . Evidence also suggests that patients who have a mental health diagnosis are less likely to have pain relief from nonpharmacologic treatments and thus have a higher rate of being prescribed opioids for pain 16,17 …”

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confidence: 99%

“…6 The relationship between opioid dependence or misuse with depression and anxiety has been demonstrated in previous studies. [8][9][10][11][12][13][14][15] Research has shown that a diagnosis of a mental health disorder results in an increased risk of utilization of nonmedical opioids and opioid use disorder. [13][14][15] It has been demonstrated that the existence of a mood or anxiety disorder increases the risk of opioid use or misuse, but there is also a suggestion that opioid use could also increase the risk of developing mood and anxiety disorders.…”

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confidence: 99%

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Pain Medication Use Two Years After Adolescent Idiopathic Scoliosis Fusion Surgery

Bastrom

Kelly

Upasani

et al. 2023

Spine

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Study Design. Observational case control Objective. Evaluate the prevalence of opioid use at 2 years after surgical correction of adolescent idiopathic scoliosis (AIS) and association with preoperative mental health. Summary of Background Data. Studies of opiate use have reported that up to 80% of users began their addiction with misuse of prescription opioids. Identifying opioid use and those at risk in the AIS population is critical for optimal outcomes. Methods. A query of a multi-center prospective AIS surgical fusion registry was performed to identify patients of all curve types with responses to Question 11 on the SRS-22 questionnaire at 2 years postoperative. Question 11 asks about pain medication usage for the patient’s back with 5 specific responses; narcotics daily, narcotics weekly or less, non-narcotics daily, non-narcotics weekly/less; or none. Ordinal regression was used to evaluate the association between preoperative SRS-22 Mental Health (MH) domain scores and 2 year postoperative pain medication usage. Results. 2595 patients who underwent surgery from 2002-2019 met inclusion. The average primary curve was 56±12°, average age 14.7±3 years, and 81.5% were female. Forty (1.5%) patients reported utilizing opioids 2 years after surgery and a significant difference in preoperative MH scores was observed. Patients taking daily opioids postoperatively had the lowest median preoperative MH score (3.75), followed by non-narcotic group (4), and no medication (4.2,P<0.001). Three patients reporting opioid use postoperatively reported preoperative usage. The rate of 2 year postoperative medication use based on year of surgery demonstrated a small linear decrease in opioid use over time, with a slight increase in non-opioid daily use. Conclusion. Less than 2% of patients reported taking opioids for back pain 2 years after surgical correction of AIS. A lower Mental Health score prior to surgery may place a patient at increased risk for opioid use 2 years after surgery. An analysis of year of surgery suggests that changes in prescription practices over time may be occurring. Level of Evidence. Level 4

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confidence: 82%

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confidence: 99%

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confidence: 99%

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Pain Medication Use Two Years After Adolescent Idiopathic Scoliosis Fusion Surgery

Bastrom

Kelly

Upasani

et al. 2023

Spine

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“…2019 [13] and Craft et al . 2022 [14] for full description of the study designs and sample characteristics.…”

Section: Methodsmentioning

confidence: 99%

Long‐term recovery from opioid use disorder: recovery subgroups, transition states and their association with substance use, treatment and quality of life

et al. 2023

Self Cite

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Background and Aims Limited information exists regarding individual subgroups of recovery from opioid use disorder (OUD) following treatment and how these subgroups may relate to recovery trajectories. We used multi‐dimensional criteria to identify OUD recovery subgroups and longitudinal transitions across subgroups. Design, Setting and Participants In a national longitudinal observational study in the United States, individuals who previously participated in a clinical trial for subcutaneous buprenorphine injections for treatment of OUD were enrolled and followed for an average of 4.2 years after participation in the clinical trial. Measurements We identified recovery subgroups based on psychosocial outcomes including depression, opioid withdrawal and pain. We compared opioid use, treatment utilization and quality of life among these subgroups. Findings Three dimensions of the recovery process were identified: depression, opioid withdrawal and pain. Using these three dimensions, participants were classified into four recovery subgroups: high‐functioning (minimal depression, mild withdrawal and no/mild pain), pain/physical health (minimal depression, mild withdrawal and moderate pain), depression (moderate depression, mild withdrawal and mild/moderate pain) and low‐functioning (moderate/severe withdrawal, moderate depression and moderate/severe pain). Significant differences among subgroups were observed for DSM‐5 criteria (P < 0.001) and remission status (P < 0.001), as well as with opioid use (P < 0.001), treatment utilization (P < 0.001) and quality of life domains (physical health, psychological, environment and social relationships; Ps < 0.001, Cohen’s fs ≥ 0.62). Recovery subgroup assignments were dynamic, with individuals transitioning across subgroups during the observational period. Moreover, the initial recovery subgroup assignment was minimally predictive of long‐term outcomes. Conclusions There appear to be four distinct subgroups among individuals in recovery from OUD. Recovery subgroup assignments are dynamic and predictive of contemporaneous, but not long‐term, substance use, substance use treatment utilization or quality of life outcomes.

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“…A recent study confirmed that up to 18 months after the last SUBLOCADE® injection, RECOVER study participants largely retained or improved their outcomes over time, almost half of them reported sustained abstinence for the 18-month period, and those receiving a longer duration of SUBLOCADE® had better outcomes ( Boyett et al., 2022 ). A follow up study ( Craft et al., 2022 ) at an average of 4.2 years post-treatment showed high levels of abstinence from opioids (74.1% in the past 7 days and 60% in the past 30 days). Furthermore, lower odds of opioid misuse were associated with improved quality of life and treatment effectiveness whereas higher odds of opioid misuse were associated with depression, psychological distress, opioid craving and withdrawal, and OUD symptoms (DSM 5 criteria) ( American Psychiatric Association, 2013 ).…”

Section: The Regulatory Approval Of Buprenorphine For the Treatment O...mentioning

confidence: 99%

History of the discovery, development, and FDA-approval of buprenorphine medications for the treatment of opioid use disorder

Heidbreder

Fudala

Greenwald

2023

Drug and Alcohol Dependence Reports

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Recovery from opioid use disorder: A 4-year post-clinical trial outcomes study

Cited by 4 publications

References 42 publications

Pain Medication Use Two Years After Adolescent Idiopathic Scoliosis Fusion Surgery

Pain Medication Use Two Years After Adolescent Idiopathic Scoliosis Fusion Surgery

Long‐term recovery from opioid use disorder: recovery subgroups, transition states and their association with substance use, treatment and quality of life

History of the discovery, development, and FDA-approval of buprenorphine medications for the treatment of opioid use disorder

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