Baseline characteristics and treatment outcomes in prescription opioid dependent patients with and without co-occurring psychiatric disorder
Margaret L Griffin, Dorian R Dodd, Jennifer S Potter, Lindsay S Rice, William Dickinson, Steven Sparenborg, Roger D Weiss, Margaret L Griffin, Dorian R Dodd, Jennifer S Potter, Lindsay S Rice, William Dickinson, Steven Sparenborg, Roger D Weiss
Abstract
Background: Given the growing prevalence of prescription opioid dependence and the considerable rates of additional psychopathology in drug dependence, we examined the association between the presence of a co-occurring Axis I psychiatric disorder and sociodemographic and clinical characteristics in this secondary analysis of patients entering a treatment study for dependence on prescription opioids. Treatment outcomes were also compared.
Methods: Patients dependent on prescription opioids participated in a multi-site, two-phase, randomized, controlled trial to assess different lengths of buprenorphine-naloxone pharmacotherapy and different intensities of counseling (Clinicaltrials.gov identifier: NCT00316277). Among the 653 participants entering the first phase of the trial, 360 entered the second phase, receiving 12 weeks of buprenorphine-naloxone treatment; they are reported here. Half of those participants (180/360) had a current co-occurring psychiatric disorder in addition to substance dependence.
Results: Sociodemographic characteristics were similar overall between those with and without a co-occurring psychiatric disorder, but women were 1.6 times more likely than men to have a co-occurring disorder. On several clinical indicators at baseline, participants with a co-occurring disorder had greater impairment. However, they had better opioid use outcomes at the conclusion of 12 weeks of buprenorphine-naloxone stabilization than did participants without a co-occurring disorder.
Conclusions: Prescription opioid-dependent patients with a co-occurring psychiatric disorder had a better response to buprenorphine-naloxone treatment despite demonstrating greater impairment at baseline. Additional research is needed to determine the mechanism of this finding and to adapt treatments to address this population.
Conflict of interest statement
Declaration of interest
Dr. Weiss has served as a consultant to Titan Pharmaceuticals and Reckitt Benckiser. Dr. Dickinson is a treatment advocate and speaker for Reckitt Benckiser.
The remaining authors report no conflicts of interest.
The authors alone are responsible for the content and writing of this article.
Source: PubMed