Motivational assessment of non-treatment buprenorphine research participation in heroin dependent individuals

Abstract

Background Heroin abuse remains an important public health problem, particularly in economically disadvantaged areas. Insight into this problem is gained from interviewing addicted individuals. However, we lack systematic data on factors that motivate heroin users to participate in non-treatment research that offers both financial incentives (compensation) and non-financial incentives (e.g., short-term medication). Aim To better understand the relative importance of several types of personal motivations to participate in non-treatment buprenorphine research, and to relate self-motivations to social, economic, demographic and drug use factors. Methods Heroin dependent volunteers (N = 235 total; 57 female and 178 male; 136 African American, 86 Caucasian, and 13 Other) applied for non-therapeutic buprenorphine research in an urban outpatient setting from 2004–2008. We conducted a semi-structured behavioral economic interview, after which participants ranked 11 possible motivations for research participation. Results Although the study was repeatedly described as non-treatment research involving buprenorphine, participants often ranked some treatment-related motivations as important (wanting to reduce/stop heroin use, needing a medication to get stabilized/detoxify). Some motivations correlated with income, heroin use, and years since marketing of buprenorphine. Two dimensions emerged from principal component analysis of motivation rankings: (1) treatment motivation vs. greater immediate needs, and (2) commitment to trying alternatives vs. a more accepting attitude toward traditional interventions. In summary, heroin addicts’ self-motivations to engage in non-therapeutic research are complex – they value economic gain but not exclusively or primarily – and relate to variables such as socioeconomic factors and drug use.

Heroin delay discounting: Modulation by pharmacological state, drug-use impulsivity, and intelligence.

“…Drug-use impulsivity was measured with the Impulsive Relapse Questionnaire (IRQ, developed by Krebaum et al, 2002; see Adinoff et al, 2007; Papke & Greenwald, 2012). The IRQ measures substance related, impulsive relapse potential and consists of 30 items measured on a 5-point Likert scale (‘strongly agree’ to ‘strongly disagree’).…”

Predictors of buprenorphine initial outpatient maintenance and dose taper response among non-treatment-seeking heroin dependent volunteers

“…While NTS individuals surpass treatment-seeking individuals in number, they are generally similar to treatment-seeking individuals in addiction severity and duration of use (Rounsaville and Kleber, 1985, Carroll and Rounsaville, 1992). Additionally, NTS heroin dependent individuals have been found to partly endorse motivation to quit using heroin and report prior attempts to do so (Papke and Greenwald, 2012). …”