The Influence of Co-Occurring Substance Use on the Effectiveness of Opiate Treatment Programs According to Intervention Type

Blondino, Courtney; Gormley, Mirinda Ann; Taylor, Da Shaunda D H; Lowery, Elizabeth; Clifford, James S.; Burkart, Benjamin; Graves, Whitney C; Lü, Juan; Prom‐Wormley, Elizabeth

doi:10.1093/epirev/mxaa005

Cited by 14 publications

(42 citation statements)

References 100 publications

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“…The primary studies included in the systematic reviews were mainly non-randomized studies (e.g., prospective cohort studies, retrospective cohort studies, retrospective chart reviews, cross-sectional studies, and secondary analyses of clinical trials) as well as a small number of randomized controlled trials (RCTs). A meta-analysis was attempted in 1 systematic review 16 of the 5 included systematic reviews [12][13][14][15][16] ; however, due to high heterogeneity the results could only be described qualitatively. In the 3 systematic reviews 12,13,15 with broader inclusion criteria than those of the current review, there were 2 RCTs in each of 2 systematic reviews 12,15 (i.e., 4 unique RCTs) and 1 RCT and 7 non-randomized studies in 1 systematic review 13 that were relevant to the current review.…”

Section: Methodsmentioning

confidence: 99%

“…A meta-analysis was attempted in 1 systematic review 16 of the 5 included systematic reviews [12][13][14][15][16] ; however, due to high heterogeneity the results could only be described qualitatively. In the 3 systematic reviews 12,13,15 with broader inclusion criteria than those of the current review, there were 2 RCTs in each of 2 systematic reviews 12,15 (i.e., 4 unique RCTs) and 1 RCT and 7 non-randomized studies in 1 systematic review 13 that were relevant to the current review. Overall, the number of non-randomized studies included in the remaining 2 systematic reviews 14,16 ranged from 23 to 41.…”

Section: Methodsmentioning

confidence: 99%

“…Five systematic reviews, [12][13][14][15][16] 1 non-randomized study, 17 and 1 evidence-based guideline 18 are included in this report.…”

Section: Summary Of Study Characteristicsmentioning

confidence: 99%

“…Three systematic reviews 12,13,15 had inclusion criteria that were broader than those of the current review. One systematic review 12 included both human and animal studies as well as people with substance use disorders other than OUD, 1 systematic review 13 examined the effects of co-occurring substances in addition to cannabis on treatment outcomes in people with OUD, and 1 systematic review 15 evaluated the effects of cannabis on people with mental disorders in addition to those with opioid dependence. Only the subset of primary studies from these systematic reviews that met the inclusion criteria for the current review are presented in this report.…”

Section: Summary Of Study Characteristicsmentioning

confidence: 99%

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Cannabis for Opioid Use Disorder

Palylyk-Colwell¹,

Bailey²

2022

cjht

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Evidence is inconsistent and of very low to moderate quality for the clinical effectiveness of cannabis regarding treatment retention and adherence, craving and withdrawal symptoms, or illicit opioid or other substance use. There is lack of consensus in the included publications as to whether use of cannabis in opioid use disorder is beneficial or detrimental. No evidence of an impact of cannabis on quality of life, functioning, satisfaction, relapse, hospitalizations, or overdoses in people with opioid use disorder was identified. One evidence-based guideline developed by health care and allied health professionals in Canada strongly recommends against the use of cannabinoids for the treatment of opioid use disorder in the primary care setting due to no or inconclusive evidence.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…Five systematic reviews, [12][13][14][15][16] 1 non-randomized study, 17 and 1 evidence-based guideline 18 are included in this report.…”

Section: Summary Of Study Characteristicsmentioning

confidence: 99%

Section: Summary Of Study Characteristicsmentioning

confidence: 99%

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Cannabis for Opioid Use Disorder

Palylyk-Colwell¹,

Bailey²

2022

cjht

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“…Given the striking increase in methamphetamine/amphetamine use both generally and among people with OUD specifically, as well as the highly addictive nature of methamphetamine and associated adverse effects, it is important to understand how use of these substances impacts receipt of and outcomes associated with MOUD. Blondino and colleagues published a systematic review of studies conducted in the United States and published before 11/28/2018 that examined associations between co-occurring substance use and retention in MOUD and opioid abstinence during MOUD, and summarized 7 articles assessing associations between amphetamine use and these 2 outcomes [ 22 ]. In order to more fully understand existing research and gaps in knowledge regarding the impact of methamphetamine/amphetamine use on MOUD—including its impact on the entire MOUD care continuum, potential trends reflecting changes in drug use patterns and MOUD provision, and potential variation across settings—an expanded review is needed that includes studies examining receipt of MOUD, studies published more recently, and studies conducted outside of the United States.…”

Section: Introductionmentioning

confidence: 99%

The impact of methamphetamine/amphetamine use on receipt and outcomes of medications for opioid use disorder: a systematic review

Frost

Lampert

Tsui

et al. 2021

Addict Sci Clin Pract

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Background Methamphetamine/amphetamine use has sharply increased among people with opioid use disorder (OUD). It is therefore important to understand whether and how use of these substances may impact receipt of, and outcomes associated with, medications for OUD (MOUD). This systematic review identified studies that examined associations between methamphetamine/amphetamine use or use disorder and 3 classes of outcomes: (1) receipt of MOUD, (2) retention in MOUD, and (3) opioid abstinence during MOUD. Methods We searched 3 databases (PubMed/MEDLINE, PsycINFO, CINAHL Complete) from 1/1/2000 to 7/28/2020 using key words and subject headings, and hand-searched reference lists of included articles. English-language studies of people with documented OUD/opioid use that reported a quantitative association between methamphetamine/amphetamine use or use disorder and an outcome of interest were included. Study data were extracted using a standardized template, and risk of bias was assessed for each study. Screening, inclusion, data extraction and bias assessment were conducted independently by 2 authors. Study characteristics and findings were summarized for each class of outcomes. Results Thirty-nine studies met inclusion criteria. Studies generally found that methamphetamine/amphetamine use or use disorder was negatively associated with receiving methadone and buprenorphine; 2 studies suggested positive associations with receiving naltrexone. Studies generally found negative associations with retention; most studies finding no association had small samples, and these studies tended to examine shorter retention timeframes and describe provision of adjunctive services to address substance use. Studies generally found negative associations with opioid abstinence during treatment among patients receiving methadone or sustained-release naltrexone implants, though observed associations may have been confounded by other polysubstance use. Most studies examining opioid abstinence during other types of MOUD treatment had small samples. Conclusions Overall, existing research suggests people who use methamphetamine/amphetamines may have lower receipt of MOUD, retention in MOUD, and opioid abstinence during MOUD. Future research should examine how specific policies and treatment models impact MOUD outcomes for these patients, and seek to understand the perspectives of MOUD providers and people who use both opioids and methamphetamine/amphetamines. Efforts to improve MOUD care and overdose prevention strategies are needed for this population.

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