Anxiety and Opioid Use Disorder: Potential Targets for Treatment and Prevention

McHugh, R. Kathryn; Taghian, Nadine R.; Nguyen, Minh Dang

doi:10.1007/s40429-020-00350-8

Cited by 8 publications

(4 citation statements)

References 58 publications

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“…Thus, it seems that these individuals are more prone to therapeutic opioid abuse and that they could use this medication trying to relieve anxiety. According to all the results, psychological variables, such as anxiety, play a key role in opioid misuse/abuse, which is in line with previous findings (for a recent review, see McHugh et al ( 2021 )). Consequently, our results seem to suggest that clinicians should screen patients’ psychological variables before beginning opioid treatment.…”

Section: Discussionsupporting

confidence: 91%

“…Therefore, evidence on the reliability and validity of the COMM was examined based on its internal structure and relation to other variables. As mentioned, previous research has suggested that individuals with anxiety and depression are more prone to develop opioid abuse (Carlson et al, 2016 ; McHugh et al, 2021 ; Sullivan et al, 2006 ). In addition, distress intolerance, considered a dispositional variable, has been shown to be related to opioid misuse in chronic pain patients who have been prescribed with opioids (McHugh et al, 2016 , 2020 ).…”

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confidence: 91%

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Spanish Validation of the COMM Scale to Assess the Misuse of Prescription Opioids in Patients with Chronic Noncancer Pain

Reyes-Pérez

López‐Martínez

Esteve

et al. 2022

Int J Ment Health Addiction

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The Current Opioid Misuse Measure (COMM) is a questionnaire used to identify and monitor chronic pain patients on opioid therapy who may be misusing their prescription opioids. The aim of the present study was to adapt the questionnaire for its use in Spanish-speaking populations. A total of 171 individuals (131 women and 40 men) with nononcological chronic pain participated in this cross-sectional study. The most frequent pain diagnoses in the sample were fibromyalgia, herniated disc, and rheumatoid arthritis. Systematic sampling was used. All individuals were interviewed at their clinic between March 2018 and February 2020. The dimensionality of the COMM-SV items was evaluated using an optimal implementation of parallel analysis (PA) and an exploratory factor analysis. Internal consistency, test–retest reliability, and criterion and convergent validity were calculated. The COMM-SV comprises five factors: problematic interpersonal behaviour, searching for more medication than prescribed, medication misuse and self-injurious thoughts, emergency use, and memory and attention problems. It has good reliability and adequate test–retest stability. The results support its criterion and convergent validity. Given the increasing use and abuse of opioids, a valid and reliable instrument is needed in Spanish settings to identify patients with chronic pain who present aberrant behaviour related to the use of these medications. The COMM-SV enables Spanish clinicians to do that.

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Section: Discussionsupporting

confidence: 91%

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confidence: 91%

Spanish Validation of the COMM Scale to Assess the Misuse of Prescription Opioids in Patients with Chronic Noncancer Pain

Reyes-Pérez

López‐Martínez

Esteve

et al. 2022

Int J Ment Health Addiction

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“…The altered activity of GABA receptors and opioid abuse may be associated with mood disorders. McHugh and coworkers (2021) have shown that anxiety responding to distress is elevated in patients suffering from opioid use disorder which is associated with the severity of misuse and appears to amplify risk via an increase in relapse and seeking for drugs [241]. Comorbidity of opioid use disorder, anxiety, and depression could impact the treatment outcomes [242].…”

Section: Inhibitory Mechanisms Of Reward-aversion In Addictionmentioning

confidence: 99%

Shared Mechanisms of GABAergic and Opioidergic Transmission Regulate Corticolimbic Reward Systems and Cognitive Aspects of Motivational Behaviors

et al. 2023

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The functional interplay between the corticolimbic GABAergic and opioidergic systems plays a crucial role in regulating the reward system and cognitive aspects of motivational behaviors leading to the development of addictive behaviors and disorders. This review provides a summary of the shared mechanisms of GABAergic and opioidergic transmission, which modulate the activity of dopaminergic neurons located in the ventral tegmental area (VTA), the central hub of the reward mechanisms. This review comprehensively covers the neuroanatomical and neurobiological aspects of corticolimbic inhibitory neurons that express opioid receptors, which act as modulators of corticolimbic GABAergic transmission. The presence of opioid and GABA receptors on the same neurons allows for the modulation of the activity of dopaminergic neurons in the ventral tegmental area, which plays a key role in the reward mechanisms of the brain. This colocalization of receptors and their immunochemical markers can provide a comprehensive understanding for clinicians and researchers, revealing the neuronal circuits that contribute to the reward system. Moreover, this review highlights the importance of GABAergic transmission-induced neuroplasticity under the modulation of opioid receptors. It discusses their interactive role in reinforcement learning, network oscillation, aversive behaviors, and local feedback or feedforward inhibitions in reward mechanisms. Understanding the shared mechanisms of these systems may lead to the development of new therapeutic approaches for addiction, reward-related disorders, and drug-induced cognitive impairment.

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“…[11][12][13] The relationship between anxiety disorders and opioid use is very complex. Although the self-medication hypothesis posits that many individuals with pre-existing anxiety attempt to manage their symptoms with opioids 14,15 Considerable evidence, including established neurobiological models, support the notion that anxiety reactions and disorders are a natural consequence of the non-prescribed use of opioids 13,16,17 At the same time, anxiety remains a concern during buprenorphine maintenance therapy, with an estimated 22% of buprenorphine-maintained individuals reporting anxiety. 18 Limited evidence suggests that co-occurring anxiety disorders in patients receiving buprenorphine may lead to drug relapse or poor retention in treatment.…”

Section: Introductionmentioning

confidence: 99%

Impact of state and trait anxiety severity on retention and phase advancement in an outpatient buprenorphine treatment program

Gokarakonda

Boydstun²,

Yilanli

et al. 2022

American J Addict

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Background and Objectives: Comorbid anxiety is common among buprenorphine patients and may lead to poorer outcomes. This study aimed to examine the prevalence and impact of anxiety severity, measured by the State-Trait Anxiety Inventory (STAI) form Y-1 & Y2 scale, on treatment outcomes (retention and phase advancement) among outpatient buprenorphine-treated patients. Methods: A retrospective chart review of 94 patients admitted to an outpatient buprenorphine treatment program was conducted. Patients were dichotomized into high and low severity groups based upon an STAI State Anxiety (S-Anxiety) and STAI Trait Anxiety (T-Anxiety) score ≥60 and <60, respectively. Associations of anxiety severity on successful phase advancement and retention during the first 90 days of treatment were assessed. Results: Twenty-one of 94 (22%) participants reported high S-Anxiety and had a significantly greater likelihood of phase advancement (OR = 12.80, 95% CI = [1.19, 136.71]) than those with low S-Anxiety. No significant associations were found between either S-Anxiety or T-Anxiety and treatment retention. Current alcohol use and UDS negative test results for THC or amphetamines were each associated with phase advancement. THC negative UDS test results were associated with 90-day treatment retention. Discussion and Conclusions: Contrary to prior reports, buprenorphine patients with higher state anxiety severity demonstrated similar retention and more rapid phase advancement than those with lower state anxiety severity.Scientific Significance: To our knowledge, this is the first study to quantify current anxiety severity using the STAI scale and evaluate its impact on treatment outcomes among buprenorphine-treated patients.

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Anxiety and Opioid Use Disorder: Potential Targets for Treatment and Prevention

Cited by 8 publications

References 58 publications

Spanish Validation of the COMM Scale to Assess the Misuse of Prescription Opioids in Patients with Chronic Noncancer Pain

Spanish Validation of the COMM Scale to Assess the Misuse of Prescription Opioids in Patients with Chronic Noncancer Pain

Shared Mechanisms of GABAergic and Opioidergic Transmission Regulate Corticolimbic Reward Systems and Cognitive Aspects of Motivational Behaviors

Impact of state and trait anxiety severity on retention and phase advancement in an outpatient buprenorphine treatment program

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