Buprenorphine Treatment for Opioid Use Disorder in Community‐Based Settings: Outcome Related to Intensity of Services and Urine Drug Test Results

Background: Previous data suggest that tapentadol, an atypical opioid with a putative dual mechanism of action, has relatively low rates of abuse. A better understanding of the rates of abuse among different prescription opioids may help clinicians when considering their potential risks and benefits. The results of urine drug tests (UDTs) may provide a unique opportunity to help answer this question.Method: To investigate different rates of prescription-opioid abuse in this retrospective study, we examined urine drug test results from patients seeking treatment at four facilities of an opioid-use-disorder (OUD) treatment program in Ohio. Urine specimens were collected on admission, one from each patient, in the regular course of care. The opioids reviewed in the present study were tapentadol, hydrocodone, oxycodone, hydromorphone, oxymorphone, and tramadol. Drug dispensing data, including morphine-milligram equivalents (MME) dispensed, were examined to adjust for the relative prevalence of each opioid being examined.Results: Data from 4,162 patients were examined. Tapentadol was the least common finding in UDT results in this cohort and remained so after adjusting for drug availability. The percentage of specimens positive for a given opioid ranged from 0.12 percent (tapentadol) to 7.04 percent (oxycodone). The availability and MME adjustments resulted in a change of rank order, with tapentadol remaining the lowest but tramadol replacing oxycodone as the prescription opioid with the highest rate of abuse.Conclusions: In this sample of UDT results from patients seeking treatment at an OUD program in Ohio, tapentadol was the least frequent finding among the opioids examined, and this remained true when adjusting for dispensing data. Factors potentially contributing to this difference may include pharmacological properties unique to tapentadol. Several important limitations notwithstanding, these findings are consistent with previous real-world evidence and warrant an ongoing line of inquiry.

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Mobile, Community‐Based Buprenorphine Treatment for Veterans Experiencing Homelessness With Opioid Use Disorder: A Pilot, Feasibility Study

American Journal on Addictions ◽

10.1111/ajad.13055 ◽

2020 ◽

Vol 29 (6) ◽

pp. 485-491 ◽

Cited By ~ 1

Author(s):

Theddeus Iheanacho ◽

Kevin Payne ◽

Jack Tsai

Keyword(s):

Feasibility Study ◽

Opioid Use Disorder ◽

Opioid Use ◽

Community Based ◽

Mobile Community ◽

Pilot Feasibility Study ◽

Buprenorphine Treatment

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Rate of Fentanyl Positivity Among Urine Drug Test Results Positive for Cocaine or Methamphetamine

JAMA Network Open ◽

10.1001/jamanetworkopen.2019.2851 ◽

2019 ◽

Vol 2 (4) ◽

pp. e192851 ◽

Cited By ~ 23

Author(s):

Leah LaRue ◽

Robert K. Twillman ◽

Eric Dawson ◽

Penn Whitley ◽

Melissa A. Frasco ◽

...

Keyword(s):

Test Results ◽

Drug Test ◽

Urine Drug ◽

Urine Drug Test

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Evaluation of Trends of Near-Real-Time Urine Drug Test Results for Methamphetamine, Cocaine, Heroin, and Fentanyl

JAMA Network Open ◽

10.1001/jamanetworkopen.2019.18514 ◽

2020 ◽

Vol 3 (1) ◽

pp. e1918514 ◽

Cited By ~ 10

Author(s):

Robert K. Twillman ◽

Eric Dawson ◽

Leah LaRue ◽

Maria G. Guevara ◽

Penn Whitley ◽

...

Keyword(s):

Real Time ◽

Test Results ◽

Drug Test ◽

Urine Drug ◽

Urine Drug Test

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Reduced urinary opioid levels from pain management patients associated with marijuana use

Pain Management ◽

10.2217/pmt-2019-0017 ◽

2019 ◽

Vol 9 (5) ◽

pp. 441-447

Author(s):

Melissa M Goggin ◽

Breane J Shahriar ◽

Andy Stead ◽

Gregory C Janis

Keyword(s):

Pain Management ◽

Drug Testing ◽

Marijuana Use ◽

Potential Interaction ◽

Test Results ◽

Opioid Use ◽

Target Drug ◽

Urine Drug ◽

Urine Drug Test ◽

Lower Urinary

Aim: Marijuana use has been postulated to modulate opioid use, dependence and withdrawal. Broad target drug testing results provide a unique perspective to identify any potential interaction between marijuana use and opioid use. Materials & methods: Using a dataset of approximately 800,000 urine drug test results collected from pain management patients of a time from of multiple years, creatinine corrected opioid levels were evaluated to determine if the presence of the primary marijuana marker 11-nor-carboxy-tetrahydrocannabinol (THC-COOH) was associated with statistical differences in excreted opioid concentrations. Results & conclusion: For each of the opioids investigated (codeine, morphine, hydrocodone, hydromorphone, oxycodone, oxymorphone, fentanyl and buprenorphine), marijuana use was associated with statistically significant lower urinary opiate levels than in samples without indicators of marijuana use.

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