Reversal of increases in methadone distribution for opioid use disorder in the US during the COVID-19 pandemic

Kennalley, Amy L.; Furst, John A.; Mynarski, Nicholas J.; McCall, Kenneth L.; Piper, Brian J.

doi:10.1101/2022.03.09.22272154

Cited by 5 publications

(1 citation statement)

References 52 publications

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“…To address this critical gap, here, we report findings of the first experimental human study designed to investigate the acute effects of THC-the main psychoactive component of cannabis-among persons with OUD who are receiving methadone treatment, a first-line opioid agonist therapy for OUD. 34,35 In this within-subject, randomized, placebo-controlled, crossover study, methadone-maintained participants were assigned to receive a single oral dose of THC (10 and 20 mg), administered as dronabinol, or placebo, across three randomly ordered test sessions. Pain sensitivity in response to THC administration was measured using experimental assays that have predictive validity for pain therapeutics and self-reported pain responses.…”

Section: Introductionmentioning

confidence: 99%

Delta‐9‐tetrahydrocannabinol modulates pain sensitivity among persons receiving opioid agonist therapy for opioid use disorder: A within‐subject, randomized, placebo‐controlled laboratory study

De Aquino,

Meyerovich,

Xie

et al. 2023

Addiction Biology

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The opioid and cannabinoid receptor systems are inextricably linked—overlapping at the anatomical, functional and behavioural levels. Preclinical studies have reported that cannabinoid and opioid agonists produce synergistic antinociceptive effects. Still, there are no experimental data on the effects of cannabinoid agonists among humans who receive opioid agonist therapies for opioid use disorder (OUD). We conducted an experimental study to investigate the acute effects of the delta‐9‐tetrahydrocannabinol (THC) among persons receiving methadone therapy for OUD. Using a within‐subject, crossover, human laboratory design, 25 persons on methadone therapy for OUD (24% women) were randomly assigned to receive single oral doses of THC (10 or 20 mg, administered as dronabinol) or placebo, during three separate 5‐h test sessions. Measures of experimental and self‐reported pain sensitivity, abuse potential, cognitive performance and physiological effects were collected. Mixed‐effects models examined the main effects of THC dose and interactions between THC (10 and 20 mg) and methadone doses (low‐dose methadone defined as <90 mg/day; high dose defined as >90 mg/day). Results demonstrated that, for self‐reported rather than experimental pain sensitivity measures, 10 mg THC provided greater relief than 20 mg THC, with no substantial evidence of abuse potential, and inconsistent dose‐dependent cognitive adverse effects. There was no indication of any interaction between THC and methadone doses. Collectively, these results provide valuable insights for future studies aiming to evaluate the risk–benefit profile of cannabinoids to relieve pain among individuals receiving opioid agonist therapy for OUD, a timely endeavour amidst the opioid crisis.

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Section: Introductionmentioning

confidence: 99%

Delta‐9‐tetrahydrocannabinol modulates pain sensitivity among persons receiving opioid agonist therapy for opioid use disorder: A within‐subject, randomized, placebo‐controlled laboratory study

De Aquino,

Meyerovich,

Xie

et al. 2023

Addiction Biology

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Evolution of the substance use landscape: Implications for contingency management

Goodwin,

Kirby,

Raiff

2024

J of App Behav Analysis

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Contingency management (CM), which involves the delivery of incentives upon meeting behavioral goals, has the potential to improve substance use treatment outcomes. The intervention allows for flexibility through numerous modifiable components including changes to incentive magnitude and schedule, target behavior, and intervention structure. Unfortunately, numerous changes in the substance use landscape have occurred in the past 10 to 15 years: Substances are more potent, overdose risk has increased, new substances and methods of use have been introduced, and substance classes are increasingly being intentionally and unintentionally mixed. These developments potentially undermine CM outcomes. We explored recent substance use changes due to legislative, regulatory, social, and economic factors for four substance classes: stimulants, opioids, tobacco, and cannabis. We discuss potential adjustments to the modifiable components of CM for future research in response to these changes. By continually adapting to the shifting substance use landscape, CM can maintain optimal efficacy.

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Examination of methadone involved overdoses during the COVID-19 pandemic

Kaufman

Kennalley

McCall

et al. 2023

Forensic Science International

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Reversal of increases in methadone distribution for opioid use disorder in the US during the COVID-19 pandemic

Cited by 5 publications

References 52 publications

Delta‐9‐tetrahydrocannabinol modulates pain sensitivity among persons receiving opioid agonist therapy for opioid use disorder: A within‐subject, randomized, placebo‐controlled laboratory study

Delta‐9‐tetrahydrocannabinol modulates pain sensitivity among persons receiving opioid agonist therapy for opioid use disorder: A within‐subject, randomized, placebo‐controlled laboratory study

Evolution of the substance use landscape: Implications for contingency management

Examination of methadone involved overdoses during the COVID-19 pandemic

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