Details

Autor(en) / Beteiligte

• Hefner, Kathryn
• Choo, Tse-Hwei
• Shmueli-Blumberg, Dikla
• Pavlicova, Martina
• King, Jacquie
• Fishman, Marc
• Shulman, Matisyahu
• Campbell, Aimee
• Greiner, Miranda
• Scodes, Jennifer
• Meyers-Ohki, Sarah
• Novo, Patricia
• Nunes, Edward
• Rotrosen, John

Titel

Time-lagged association between counseling and/or 12-Step attendance with subsequent opioid use in a secondary analysis from a randomized, clinical trial of medications for opioid use disorder

Ist Teil von

• Drug and alcohol dependence reports, 2022-12, Vol.5, p.100100, Article 100100

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2022

Link zum Volltext

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• •Counseling and 12-Step attendance were associated with later reduced opioid use.•Associations between psychosocial support and use grew over weeks of the trial.•12-Step had a larger association with reduced opioid use for those on naltrexone.•Group counseling had larger association with reduced use for buprenorphine-naloxone.•Relationship between psychosocial support and use are not causal; may be reciprocal. Psychosocial support is recommended in conjunction with medication for opioid use disorder (MOUD), although optimal “dose,” modality, and timing of participation is not established. This study comprised a secondary analysis of counseling and 12-Step attendance and subsequent opioid use in a MOUD randomized clinical trial. Methods: The parent study randomly assigned 570 participants to receive buprenorphine-naloxone (BUP-NX, n=287) or extended-release injectable naltrexone (XR-NTX, n=283). Mixed-effects logistic regression models were fit with opioid use as the response variable, and a counseling/12-Step attendance predictor. Differences by treatment assignment were examined. Results: Any counseling or 12-Step attendance was associated with reduced odds of opioid use at the subsequent visit, whether considered individually or aggregated across type. A continuous relationship was observed for 12-Step attendance (F(1,5083)=5.01, p=.025); with each additional hour associated with 13% (95% CI: 0.83, 0.90) reduction in odds of opioid use. The strength of this association grew over time. In the BUP-NX arm, group counseling was associated with a greater reduction in odds of opioid use than for XR-NTX, (OR=0.32 (95% CI: .22, 0.48) vs. OR=0.69 (95% CI: 0.43, 1.08)). For XR-NTX, 12-Step was associated with a greater reduction in odds of opioid use (OR=0.35 (95% CI: 0.22, 0.54) vs. OR=0.65 (95% CI: 0.47, 0.89) for BUP-NX)). Conclusions: Psychosocial engagement has a proximal association with opioid use, the strength of that association may grow with dose and time. Alternatively, more motivated individuals may both attend more counseling/12-Step and have better treatment outcomes, or the relationship may be reciprocal.