scholarly journals Impact of Current Pain Status on Low-Barrier Buprenorphine Treatment Response Among Patients with Opioid Use Disorder

Pain Medicine ◽  
2021 ◽  
Author(s):  
Kelly R Peck ◽  
Taylor A Ochalek ◽  
Joanna M Streck ◽  
Gary J Badger ◽  
Stacey C Sigmon
Keyword(s):  
Treatment Outcomes ◽  
Severity Index ◽  
Opioid Use Disorder ◽  
Addiction Severity Index ◽  
Brief Symptom Inventory ◽  
Opioid Use ◽  
Global Severity Index ◽  
Pain Status ◽  
The Impact ◽  
Buprenorphine Treatment

Abstract Objective Chronic non-cancer pain (CNCP) is prevalent among individuals with opioid use disorder (OUD). However, the impact of CNCP on buprenorphine treatment outcomes is largely unknown. In this secondary analysis, we examined treatment outcomes among individuals with and without CNCP who received a low-barrier buprenorphine maintenance regimen during waitlist delays to more comprehensive opioid treatment. Methods Participants were 28 adults with OUD who received 12 weeks of buprenorphine treatment involving bimonthly clinic visits, computerized medication dispensing, and phone-based monitoring. At intake and monthly follow-up assessments, participants completed the Brief Pain Inventory, Beck Anxiety Inventory, Beck Depression Inventory (BDI-II), Brief Symptom Inventory (BSI), Addiction Severity Index, and staff-observed urinalysis. Results Participants with CNCP (n = 10) achieved comparable rates of illicit opioid abstinence as those without CNCP (n = 18) at weeks 4 (90% vs 94%), 8 (80% vs 83%), and 12 (70% vs 67%) (P = 0.99). Study retention was also similar, with 90% and 83% of participants with and without CNCP completing the 12-week study, respectively (P = 0.99). Furthermore, individuals with CNCP demonstrated significant improvements on the BDI-II and Global Severity Index subscale of the BSI (P < 0.05). However, those with CNCP reported more severe medical problems and smaller reductions in legal problems relative to those without CNCP (P = 0.03). Conclusions Despite research suggesting that chronic pain may influence OUD treatment outcomes, participants with and without CNCP achieved similar rates of treatment retention and significant reductions in illicit opioid use and psychiatric symptomatology during low-barrier buprenorphine treatment.

The Impact of Chronic Pain on Opioid Use Disorder Treatment Outcomes

2021 ◽  
Author(s):  
R. Ross MacLean ◽  
Suzanne Spinola ◽  
Gabriella Garcia-Vassallo ◽  
Mehmet Sofuoglu
Keyword(s):  
Chronic Pain ◽  
Treatment Outcomes ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Disorder Treatment ◽  
The Impact

Treatment Outcomes in Individuals Diagnosed with Comorbid Opioid Use Disorder and Posttraumatic Stress Disorder: A Review

2021 ◽  
pp. 107026
Author(s):  
Sarah Meshberg-Cohen ◽  
R. Ross MacLean ◽  
Ashley M. Schnakenberg Martin ◽  
Mehmet Sofuoglu ◽  
Ismene L. Petrakis
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Treatment Outcomes ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Opioid Use Disorder ◽  
Opioid Use

scholarly journals Assessment of the impact of an opioid-specific education series on rates of medication-assisted treatment for opioid use disorder in veterans

2020 ◽  
Author(s):  
Taylor Kirby ◽  
Robert Connell ◽  
Travis Linneman
Keyword(s):  
Multivariate Analysis ◽  
Hospital Admission ◽  
Intervention Group ◽  
Opioid Use Disorder ◽  
Control Group ◽  
Opioid Use ◽  
Motivation To Change ◽  
Heroin Use ◽  
Ed Visits ◽  
The Impact

Abstract Purpose The impact of a focused inpatient educational intervention on rates of medication-assisted therapy (MAT) for veterans with opioid use disorder (OUD) was evaluated. Methods A retrospective cohort analysis compared rates of MAT, along with rates of OUD-related emergency department (ED) visits and/or hospital admission within 1 year, between veterans with a diagnosis of OUD who completed inpatient rehabilitation prior to implementation of a series of group sessions designed to engage intrinsic motivation to change behavior surrounding opioid abuse and provide education about MAT (the control group) and those who completed rehabilitation after implementation of the education program (the intervention group). A post hoc, multivariate analysis was performed to evaluate possible predictors of MAT use and ED and/or hospital readmission, including completion of the opioid series, gender, age (>45 years), race, and specific prior substance(s) of abuse. Results One hundred fifty-eight patients were included: 95 in the control group and 63 in the intervention group. Rates of MAT were 25% (24 of 95 veterans) and 75% (47 of 63 veterans) in control and intervention groups, respectively (P < 0.01). Gender, completion of the opioid series, prior heroin use, and marijuana use met prespecified significance criteria for inclusion in multivariate regression modeling of association with MAT utilization, with participation in the opioid series (odds ratio [OR], 9.56; 95% confidence interval [CI], 4.36-20.96) and prior heroin use (OR, 3.26; 95% CI, 1.18-9.01) found to be significant predictors of MAT utilization on multivariate analysis. Opioid series participation and MAT use were independently associated with decreased rates of OUD-related ED visits and/or hospital admission (hazard ratios of 0.16 [95% CI, 0.06-0.44] and 0.32 [95% CI, 0.14-0.77], respectively) within 1 year after rehabilitation completion. Conclusion Focused OUD-related education in a substance abuse program for veterans with OUD increased rates of MAT and was associated with a decrease in OUD-related ED visits and/or hospital admission within 1 year.

Impact of High Deductible Health Plans on Continuous Buprenorphine Treatment for Opioid Use Disorder

2021 ◽  
Author(s):  
Alene Kennedy-Hendricks ◽  
Cameron J. Schilling ◽  
Alisa B. Busch ◽  
Elizabeth A. Stuart ◽  
Haiden A. Huskamp ◽  
...  
Keyword(s):  
Opioid Use Disorder ◽  
Health Plans ◽  
Opioid Use ◽  
Buprenorphine Treatment

scholarly journals Conceptualizing the effects of the COVID-19 pandemic on people with opioid use disorder: an application of the social ecological model

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ethan Cowan ◽  
Maria R. Khan ◽  
Siri Shastry ◽  
E. Jennifer Edelman
Keyword(s):  
Structural Changes ◽  
Ecological Model ◽  
Disease Incidence ◽  
Opioid Use Disorder ◽  
Social Ecological Model ◽  
Physical And Mental Health ◽  
Opioid Use ◽  
Social Ecological ◽  
The Social ◽  
The Impact

AbstractThe COVID-19 pandemic has resulted in unparalleled societal disruption with wide ranging effects on individual liberties, the economy, and physical and mental health. While no social strata or population has been spared, the pandemic has posed unique and poorly characterized challenges for individuals with opioid use disorder (OUD). Given the pandemic’s broad effects, it is helpful to organize the risks posed to specific populations using theoretical models. These models can guide scientific inquiry, interventions, and public policy. Models also provide a visual image of the interplay of individual-, network-, community-, structural-, and pandemic-level factors that can lead to increased risks of infection and associated morbidity and mortality for individuals and populations. Such models are not unidirectional, in that actions of individuals, networks, communities and structural changes can also affect overall disease incidence and prevalence. In this commentary, we describe how the social ecological model (SEM) may be applied to describe the theoretical effects of the COVID-19 pandemic on individuals with opioid use disorder (OUD). This model can provide a necessary framework to systematically guide time-sensitive research and implementation of individual-, community-, and policy-level interventions to mitigate the impact of the COVID-19 pandemic on individuals with OUD.

scholarly journals Project ECHO and primary care buprenorphine treatment for opioid use disorder: Implementation and clinical outcomes

2021 ◽  
pp. 1-9
Author(s):  
James B. Anderson ◽  
Stephen A. Martin ◽  
Anne Gadomski ◽  
Nicole Krupa ◽  
Daniel Mullin ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Outcomes ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Project Echo ◽  
Buprenorphine Treatment

scholarly journals Buprenorphine Induction in a Rural Maryland Detention Center During COVID-19: Implementation and Preliminary Outcomes of a Novel Telemedicine Treatment Program for Incarcerated Individuals With Opioid Use Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Annabelle M. Belcher ◽  
Kelly Coble ◽  
Thomas O. Cole ◽  
Christopher J. Welsh ◽  
Anna Whitney ◽  
...  
Keyword(s):  
Opioid Use Disorder ◽  
Community Treatment ◽  
Successful Implementation ◽  
Opioid Use ◽  
Screening Process ◽  
Detention Center ◽  
Medication Prescription ◽  
Proven Efficacy ◽  
Pass Through ◽  
Buprenorphine Treatment

Over 10 million individuals pass through U.S. detention centers on an annual basis, with nearly two-thirds meeting criteria for drug dependence/abuse. Despite proven efficacy, treatment with medications for opioid use disorder (MOUD) is underutilized in jail settings—a gap that could be addressed using telemedicine. Here we describe a new program of telemedicine-based clinical provision of new/continuing buprenorphine treatment for individuals detained in a rural jail. Implementation objectives were completed between January and August 2020, and patient encounters were conducted between August 2020 and February 2021. We established (i) telemedicine hardware/software capability; (ii) a screening process; (iii) buprenorphine administration methods; (iv) necessary medical release procedures; (v) telemedicine encounter coordination and medication prescription procedures; and (vi) a research platform. Seven incarcerated patients have been treated, two of whom were referred from community treatment. Patients were mostly male (71%), non-Hispanic White (86%), and averaged 33 years old. All patients tested positive for an opioid upon intake and began/continued buprenorphine treatment in the jail. Average time to first MOUD appointment was 9 days and patients were maintained in treatment an average 21 days. Referrals for continuing community treatment were offered to all patients prior to discharge. We report successful implementation of telemedicine MOUD in a rural detention center, with treatment engagement and initiation occurring prior to the high-risk period of discharge. The fact that this program was launched during the height of the pandemic highlights the flexibility of telemedicine-based buprenorphine treatment. Challenges and obstacles to implementation of buprenorphine treatment in a correctional system are discussed.

scholarly journals The role of social network support in treatment outcomes for medication for opioid use disorder: a systematic review

2020 ◽  
Author(s):  
Navin Kumar ◽  
William Oles ◽  
Benjamin A. Howell ◽  
Kamila Janmohamed ◽  
Selena T. Lee ◽  
...  
Keyword(s):  
Social Networks ◽  
Social Network ◽  
Treatment Outcomes ◽  
Opioid Use Disorder ◽  
Social Connections ◽  
Opioid Use ◽  
Network Support ◽  
Social Network Support ◽  
Partner Relationships

AbstractBackgroundSocial connections can lead to contagion of healthy behaviors. Successful treatment of patients with opioid use disorder, as well as recovery of their communities from the opioid epidemic, may lay in rebuilding social networks. Strong social networks of support can reinforce the benefits of medication treatments that are the current standard of care and the most effective tool physicians have to fight the opioid epidemic.MethodsWe conducted a systematic review of electronic research databases, specialist journals and grey literature up to August 2020 to identify experimental and observational studies of social network support in patient populations receiving medication for opioid use disorder (MOUD). We place the studies into a conceptual framework of dynamic social networks, examining the role of networks before MOUD treatment is initiated, during the treatment, and in the long-term following the treatment. We analyze the results across three sources of social network support: partner relationships, family, and peer networks. We also consider the impact of negative social connections.ResultsOf 5193 articles screened, 46 studies were identified as meeting inclusion criteria (12 were experimental and 34 were observational). 39 studies indicated that social network support, or lack thereof, had a statistically significant relationship with improved MOUD treatment outcomes. We find the strongest support for the positive impact of family and partner relationships when integrated into treatment attempts. We also identify strong evidence for a negative impact of maintaining contacts with the drug-using network on treatment outcomes.ConclusionsSocial networks significantly shape effectiveness of opioid use disorder treatments. While negative social ties reinforce addiction, positive social support networks can amplify the benefits of medication treatments. Targeted interventions to reconstruct social networks can be designed as a part of medication treatment with their effects evaluated in improving patients’ odds of recovery from opioid use disorder and reversing the rising trend in opioid deaths.

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