Outcome predictors for patients receiving methadone maintenance treatment: findings from a retrospective multi-site study

Proctor, Steven L.; Copeland, Amy L.; Kopak, Albert M.; Hoffmann, Norman G.; Herschman, Philip L.; Polukhina, Nadiya

doi:10.3109/14659891.2015.1118564

Cited by 15 publications

(11 citation statements)

References 58 publications

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“…Four studies found a significant negative association between amphetamine use disorder or methamphetamine/amphetamine use and opioid abstinence during MOUD treatment [ 58 – 61 ]. The other 4 studies found no significant association [ 54 , 62 – 64 ].…”

Section: Resultsmentioning

confidence: 99%

The impact of methamphetamine/amphetamine use on receipt and outcomes of medications for opioid use disorder: a systematic review

Frost

Lampert

Tsui

et al. 2021

Addict Sci Clin Pract

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Background Methamphetamine/amphetamine use has sharply increased among people with opioid use disorder (OUD). It is therefore important to understand whether and how use of these substances may impact receipt of, and outcomes associated with, medications for OUD (MOUD). This systematic review identified studies that examined associations between methamphetamine/amphetamine use or use disorder and 3 classes of outcomes: (1) receipt of MOUD, (2) retention in MOUD, and (3) opioid abstinence during MOUD. Methods We searched 3 databases (PubMed/MEDLINE, PsycINFO, CINAHL Complete) from 1/1/2000 to 7/28/2020 using key words and subject headings, and hand-searched reference lists of included articles. English-language studies of people with documented OUD/opioid use that reported a quantitative association between methamphetamine/amphetamine use or use disorder and an outcome of interest were included. Study data were extracted using a standardized template, and risk of bias was assessed for each study. Screening, inclusion, data extraction and bias assessment were conducted independently by 2 authors. Study characteristics and findings were summarized for each class of outcomes. Results Thirty-nine studies met inclusion criteria. Studies generally found that methamphetamine/amphetamine use or use disorder was negatively associated with receiving methadone and buprenorphine; 2 studies suggested positive associations with receiving naltrexone. Studies generally found negative associations with retention; most studies finding no association had small samples, and these studies tended to examine shorter retention timeframes and describe provision of adjunctive services to address substance use. Studies generally found negative associations with opioid abstinence during treatment among patients receiving methadone or sustained-release naltrexone implants, though observed associations may have been confounded by other polysubstance use. Most studies examining opioid abstinence during other types of MOUD treatment had small samples. Conclusions Overall, existing research suggests people who use methamphetamine/amphetamines may have lower receipt of MOUD, retention in MOUD, and opioid abstinence during MOUD. Future research should examine how specific policies and treatment models impact MOUD outcomes for these patients, and seek to understand the perspectives of MOUD providers and people who use both opioids and methamphetamine/amphetamines. Efforts to improve MOUD care and overdose prevention strategies are needed for this population.

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Section: Resultsmentioning

confidence: 99%

The impact of methamphetamine/amphetamine use on receipt and outcomes of medications for opioid use disorder: a systematic review

Frost

Lampert

Tsui

et al. 2021

Addict Sci Clin Pract

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“…This study extends the literature by evaluating the association between illicit opioid use and loneliness among a multi-site sample of MMT patients. We hypothesized that patients would be significantly more likely to report illicit opioid use when they had moderate or severe loneliness relative to little or no loneliness, controlling for patient and treatment characteristics (treatment episode, treatment duration, and methadone dose) that are associated with MMT outcomes (Nosyk et al, 2009;Proctor et al, 2016;Vigna-Taglianti et al, 2016;Ward, Mattick, & Hall, 1998). We further predicted that the association between illicit opioid use and loneliness would be significantly stronger for women than for men.…”

Section: The Present Studymentioning

confidence: 99%

“…We further predicted that the association between illicit opioid use and loneliness would be significantly stronger for women than for men. We controlled for age, marital status, work status, and depressive symptoms as potential confounding factors that are linked to both illicit opioid use (e.g., Havard, Teesson, Darke, & Ross, 2006;Proctor et al, 2016;Vigna-Taglianti et al, 2016) and loneliness (e.g., Cacioppo, Hawkley, & Thisted, 2010;Ge, Yap, Ong, & Heng, 2017;Hawkley, Browne, & Cacioppo, 2005;Luhmann & Hawkley, 2016).…”

Section: The Present Studymentioning

confidence: 99%

Loneliness and Illicit Opioid Use Among Methadone Maintenance Treatment Patients

Polenick

Cotton

Bryson

et al. 2019

Substance Use & Misuse

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Background: Loneliness has been linked to greater substance use, especially among women. Yet little is known about how loneliness is associated with treatment outcomes for patients with opioid use disorder (OUD). Objectives: We evaluated how patient reports of using illicit opioids (i.e., heroin or nonprescription pain medications) are linked to perceptions of loneliness in a sample of adults receiving methadone maintenance treatment (MMT), and whether this link varies by gender. Methods: Participants for this cross-sectional observational study included 371 MMT patients aged 18 and older drawn from four opioid treatment programs in Southern New England and the Pacific Northwest. Patients completed a self-administered survey assessing sociodemographic and health information, loneliness, illicit opioid use, and MMT characteristics. Logistic regressions were estimated to examine the link between patient odds of illicit opioid use in the past month and perceived loneliness. Results: Patient gender moderated the association between illicit opioid use and loneliness such that severe loneliness was associated with higher odds of using illicit opioids among women (OR = 3.00, 95% CI [1.19, 7.57], p = .020) but lower odds of using illicit opioids among men (OR = 0.35, 95% CI [0.14, 0.87], p = .024), accounting for age, marital status, work status, depressive symptoms, and MMT characteristics (treatment episode, treatment duration, and methadone dose).

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“…Among the 2467 unique citations screened, 23 studies were included in the qualitative synthesis (Figure 1). 13,14,17,20,[30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48] Interrater agreement was acceptable for both title/abstract (κ = 0.63, 95% confidence interval 0.57-0.69) and full-text screening (κ = 0.60, 95% confidence interval 0.45-0.74). Although we did not apply any age restrictions, all studies were of adult populations.…”

Section: Resultsmentioning

confidence: 99%

“…Twelve studies examined the relation between cannabis use and continued opioid use, with a total sample size of 3676. 13,14,20,[30][31][32][33][34][35][36]38,46 The majority of the studies showed no association between cannabis use and opioid use (Table 1).…”

Section: Continued Opioid Usementioning

confidence: 99%

Cannabis use during methadone maintenance treatment for opioid use disorder: a systematic review and meta-analysis

McBrien

Luo

Sanger

et al. 2019

cmajo

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T he opioid epidemic related to an increase in prescriptions [1][2][3][4] has escalated in the past 2 decades. Opioid use disorder is a fundamental component of this crisis. 5,6 Despite the morbidity and mortality due to opioid use disorder, high rates of HIV infection and hepatitis C among patients with the disorder and high unemployment rates, treatment options are limited in scope and effectiveness. 7,8 Methadone maintenance therapy is the most common treatment for opioid use disorder, 9,10 although other treatments are available. 11 Despite the reported benefits of methadone maintenance therapy in managing opioid use disorder, the number of patients receiving this therapy who continue to use illicit opioids is high. 12 The rates of cannabis use among patients receiving methadone maintenance therapy are higher than those in the general population: about a third of Canadians have used cannabis once in their lifetime, 13 whereas 59.7% of males and 43.5% of females receiving methadone maintenance therapy reported having used cannabis. [14][15][16] Research suggests that polydrug use (aside from cannabis) is prevalent in the methadone maintenance therapy population. 17,18 There is limited evidence to suggest that cannabis use may reduce opioid use in pain management 19 but not in opioid use disorder. 20 Studies have shown that, in US states with dispensary-based medical cannabis laws, fewer prescription opioids are dispensed, 21 and there are fewer opioid-related deaths. 22 The US Department of Veterans Affairs has suggested that cannabis should be legalized not only as a mechanism to lower prescription opioid use but also to manage opioid withdrawal. 23 This report made headlines labelling cannabis as an "exit drug." 23 However, the "exit hypothesis" -the idea that cannabis can be used to manage withdrawal symptoms and therefore help patients with opioid use disorder to stop using opioidshas not been examined systematically. With the legalization of

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Outcome predictors for patients receiving methadone maintenance treatment: findings from a retrospective multi-site study

Cited by 15 publications

References 58 publications

The impact of methamphetamine/amphetamine use on receipt and outcomes of medications for opioid use disorder: a systematic review

The impact of methamphetamine/amphetamine use on receipt and outcomes of medications for opioid use disorder: a systematic review

Loneliness and Illicit Opioid Use Among Methadone Maintenance Treatment Patients

Cannabis use during methadone maintenance treatment for opioid use disorder: a systematic review and meta-analysis

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