Correlates of Opioid Abstinence in a 42-Month Posttreatment Naturalistic Follow-Up Study of Prescription Opioid Dependence

Abstract

Objective: The natural course of prescription opioid use disorder has not been examined in longitudinal studies. The current study examined correlates of opioid abstinence over time after completing a treatment trial for prescription opioid dependence. Methods: The multi-site Prescription Opioid Addiction Treatment Study (POATS) examined different durations of buprenorphine-naloxone and different intensities of counseling to treat prescription opioid dependence, as assessed by DSM-IV; a longitudinal study was conducted following the clinical trial, from March 2009-January 2013. At 18, 30, and 42 months after treatment entry, telephone interviews were conducted (N=375). In this exploratory, naturalistic study, logistic regression analyses examined the association between treatment modality (including formal treatment and mutual help) and opioid abstinence rates at the follow-up assessments. Results: At the three follow-up assessments, approximately half of the participants reported engaging in current substance use disorder treatment (47-50%). The most common treatments were buprenorphine maintenance (27-35%) and mutual-help group attendance (27-30%), followed by outpatient counseling (18-23%) and methadone maintenance (4%). In adjusted analyses, current opioid agonist treatment showed the strongest association with current opioid abstinence (ORs=5.4, 4.6, and 2.8 at the three assessments), followed by current mutual-help

Online digital recovery support services: An overview of the science and their potential to help individuals with substance use disorder during COVID-19 and beyond

“…Individuals with alcohol and stimulant use disorder, as well as opioid use disorder in tandem with buprenorphine, benefit from inperson, 12-step MHO attendance and active involvement (Crits-Christoph et al, 1999;Kelly, Humphreys & Ferri, 2020;Rawson et al, 2004;Weiss et al, 2005;Weiss et al, 2019). Emerging research suggests that secular MHOs, too, such as SMART Recovery, may be as effective as 12-step MHOs for those who choose to attend after adjusting for a greater likelihood of nonabstinence goals among secular group attendees (Zemore et al, 2018).…”

Online recovery support meetings can help mitigate the public health consequences of COVID-19 for individuals with substance use disorder

“…Twelve-step MHO participation improves substance use outcomes for individuals with alcohol use disorder and stimulant use disorder, as well as opioid use disorder after receiving, or in tandem with, opioid agonist medications like buprenorphine and methadone. ( Kelly et al, 2020 , Weiss et al, 2005 , Weiss et al, 2019 ) AA participation, specifically, promotes these better outcomes by enhancing a) recovery-supportive social network changes such as adding supportive individuals to, and dropping risky individuals from, one’s network, b) coping skills, c) abstinence self-efficacy, and d) abstinence motivation. ( Kelly, 2017 ) These mechanisms of behavior change are consistent with theorized targets of other psychosocial approaches including cognitive-behavioral therapies.…”

A Nationwide Survey Study of Recovery Community Centers Supporting People in Recovery From Substance Use Disorder

“…Beyond this issue, however, ARCO and non-ARCO RCCs follow a very similar model of care that provides recovery support in a welcoming, accessible, and long-lasting way. Their strong emphasis on mutual help groups is in line with emerging research recommendations to engage people with OUD in mutual help activities 38,39 . Recovery community centers meet this need in a variety of ways, ranging from traditional 12-step meetings to more inclusive “all recovery” meetings, which are not substance specific and embrace all recovery pathways.…”

“…Their strong emphasis on mutual help groups is in line with emerging research recommendations to engage people with OUD in mutual help activities. 38,39 Recovery community centers meet this need in a variety of ways, ranging from traditional 12-step meetings to more inclusive "all recovery" meetings, which are not substance specific and embrace all recovery pathways. Within the same setting, RCCs address basic needs and social services and function as social places that offer substance free recreational events and meaningful ways to give back to the community.…”