Opioid consumption frequency and its associations with potential life problems during opioid agonist treatment in individuals with prescription-type opioid use disorder: exploratory results from the OPTIMA Study.

IF 4 2区 社会学 Q1 SUBSTANCE ABUSE Harm Reduction Journal Pub Date : 2025-02-08 DOI:10.1186/s12954-025-01157-4
Anne Bouthillier, Gabriel Bastien, Christina McAnulty, Hamzah Bakouni, Bernard Le Foll, M Eugenia Socias, Didier Jutras-Aswad
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Abstract

Background: Traditional treatment approaches for prescription-type opioid use disorder (POUD), centered on abstinence, have limitations and hinder the development of interventions that meet the needs of people with POUD. Reduction in use without complete abstinence presents a promising avenue for intervention enhancement, but supporting data is scarce regarding its translation into positive patient outcomes. This study explores whether reducing opioid use frequency (OUF) during opioid agonist treatment correlates with reduced potential life problems in individuals with POUD, including those using fentanyl.

Methods: This study is an exploratory analysis of the OPTIMA trial, a pragmatic, open-label, randomized controlled study comparing the effectiveness of flexible take-home dosing of buprenorphine/naloxone and supervised methadone in reducing opioid use amongst individuals with POUD. OUF was assessed every two weeks for 24 weeks after treatment initiation using the Timeline Followback. Potential life problems were evaluated at baseline and study completion using the Addiction Severity Index Self-Report. The 114 participants who completed both baseline and end-of-study questionnaires were included. A repeated-measures generalized linear mixed model (GLMM) was used to evaluate the influence of OUF on potential life problems.

Results: Reducing OUF was significantly associated with fewer problems related to medical status (p = 0.049), psychiatric status (p = 0.019), and alcohol problem severity (p = 0.001). The interaction was non-significant for employment (p = 0.264), family status (p = 0.352) and legal status (p = 0.050). Life improvements emerged with ≤ 21 days of opioid use per 28-day period.

Conclusion: Findings underscore the significance of harm reduction goals focusing on opioid use reduction, which translated in improvements across many life domains.

Trial registration: Study was registered with ClinicalTrials.gov (NCT03033732) prior to participant enrollment.

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处方型阿片类药物使用障碍患者阿片类药物激动剂治疗期间阿片类药物消费频率及其与潜在生命问题的关系:OPTIMA研究的探索性结果
背景:处方型阿片类药物使用障碍(POUD)的传统治疗方法以戒断为中心,存在局限性,阻碍了满足POUD患者需求的干预措施的发展。在没有完全戒断的情况下减少使用是一种有希望的干预增强途径,但关于其转化为积极的患者结果的支持数据很少。本研究探讨阿片类药物激动剂治疗期间减少阿片类药物使用频率(OUF)是否与减少POUD患者(包括使用芬太尼的患者)潜在的生命问题相关。方法:本研究是对OPTIMA试验的探索性分析,OPTIMA试验是一项实用的、开放标签的、随机对照研究,比较灵活的丁丙诺啡/纳洛酮带回家剂量和监督美沙酮在减少POUD患者阿片类药物使用方面的有效性。在治疗开始后的24周内,使用时间线随访法每两周评估一次OUF。在基线和研究完成时使用成瘾严重程度指数自我报告评估潜在的生活问题。114名参与者完成了基线和研究结束时的问卷调查。采用重复测量广义线性混合模型(GLMM)评价了OUF对潜在寿命问题的影响。结果:减少OUF与医疗状况(p = 0.049)、精神状况(p = 0.019)和酒精问题严重程度(p = 0.001)相关的问题减少显著相关。就业(p = 0.264)、家庭状况(p = 0.352)和法律状况(p = 0.050)的交互作用不显著。每28天使用阿片类药物≤21天出现生活改善。结论:研究结果强调了以减少阿片类药物使用为重点的减少危害目标的重要性,这转化为许多生活领域的改善。试验注册:研究在受试者入组前已在ClinicalTrials.gov (NCT03033732)注册。
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来源期刊
Harm Reduction Journal
Harm Reduction Journal Medicine-Public Health, Environmental and Occupational Health
CiteScore
5.90
自引率
9.10%
发文量
126
审稿时长
26 weeks
期刊介绍: Harm Reduction Journal is an Open Access, peer-reviewed, online journal whose focus is on the prevalent patterns of psychoactive drug use, the public policies meant to control them, and the search for effective methods of reducing the adverse medical, public health, and social consequences associated with both drugs and drug policies. We define "harm reduction" as "policies and programs which aim to reduce the health, social, and economic costs of legal and illegal psychoactive drug use without necessarily reducing drug consumption". We are especially interested in studies of the evolving patterns of drug use around the world, their implications for the spread of HIV/AIDS and other blood-borne pathogens.
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