Interim buprenorphine treatment during delays to comprehensive treatment: Changes in psychiatric symptoms

Abstract

Prevalence of depression, anxiety, and mood disorders among individuals with opioid use disorder far exceeds that of the general population. While psychiatric symptoms often improve upon entry into opioid treatment, this has typically been seen with treatments involving psychosocial counseling. In this secondary analysis, we examined changes in psychiatric symptoms during a randomized clinical trial evaluating an interim buprenorphine treatment without counseling among individuals awaiting entry into comprehensive treatment. Waitlisted adults with opioid use disorder (N = 50) were randomized to one of two 12-week conditions: interim buprenorphine treatment (IBT; n = 25) consisting of buprenorphine maintenance using a computerized medication dispenser, with bimonthly clinic visits and technology-assisted monitoring, or waitlist control (WLC; n = 25), wherein participants remained on the waitlist of their local clinic. All participants completed assessments of psychiatric symptoms at intake and Study Weeks 4, 8, and 12. We examined changes on the Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), Brief Symptom Inventory (BSI), and Psychiatric subscale of the Addiction Severity Index (ASI). Significant group-by-time interactions were observed for all measures of psychiatric severity examined: BAI (p < .05), BDI-II (p < .01), 5 BSI subscales (ps < .05), and the ASI Psychiatric subscale (p < .05). On all measures, IBT participants reported significantly reduced psychiatric severity at the 4-, 8-, and 12-week assessments relative to baseline. In contrast, there were no significant changes in psychiatric symptoms among WLC participants. IBT without counseling may improve psychiatric distress among waitlisted individuals with opioid use disorder. (PsycINFO Database Record

Trial registration: ClinicalTrials.gov NCT02360007.

Conflict of interest statement

Potential conflicts of interest: None

(c) 2018 APA, all rights reserved).

Figures

Figure 1

Changes over time in BAI, BDI-II, GSI, and ASI Psychiatric scores for IBT and WLC conditions. Some y-axes are presented on a smaller scale to permit detailed inspection of data. The grey horizontal lines represent established clinical cut-off scores for the BAI (≥10), BDI-II (≥17) and ASI (0.27). For all panels, error bars represent SEM, asterisks indicate a significant difference between intake and the assessment timepoint within the IBT group, and hash marks indicate that the change from intake to assessment timepoint significantly differed between IBT and WLC groups (p<.05).

Figure 2

The percentage of participants at study intake and each assessment whose GSI score exceeds the clinical cut-off (t score ≥63). The differences between groups were not statistically significant. Asterisks indicate a significant difference between intake and assessment timepoint within the IBT group. Error bars represent SEM.