Stereotype threat and social function in opioid substitution therapy patients

Hippel, Courtney von; Henry, Julie D.; Terrett, Gill; Mercuri, Kimberly; McAlear, Karen; Rendell, Peter G.

doi:10.1111/bjc.12128

Cited by 20 publications

(13 citation statements)

References 63 publications

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“…Collectively, blunted social abilities, stereotyped behavior, elevated anxiety and low nociceptive thresholds in morphine abstinent mice fit with clinical reports of social withdrawal, impaired cognitive flexibility and high comorbidity with anxiety disorder and depression in patients with a history of chronic opioid exposure (85)(86)(87)(88)(89)(90)(91)(92). Importantly, such negative affect, combined with conditioned effects of opioids, are considered as the two major causes of relapse in Opioid Use Disorder (93,94); they were both significantly alleviated in morphine abstinent mice under VU0155041 treatment.…”

Section: Chronic Facilitation Of Mglur4 Activity Relieves Behavioral Deficits and Dampens Behavioral Sensitization In Morphine Abstinent supporting

confidence: 60%

Facilitating mGluR4 activity reverses the long-term deleterious consequences of chronic morphine exposure in male mice

Becker

Pellissier

Corde

et al. 2020

Neuropsychopharmacol.

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doi: bioRxiv preprint Background: Understanding the neurobiological underpinnings of abstinence from drugs of abuse is critical to allow better recovery and ensure relapse prevention in addicted subjects. Methods: By comparing the long-term transcriptional consequences of morphine and cocaine exposure, we identified the metabotropic glutamate receptor subtype 4 (mGluR4) as a promising pharmacological target in morphine abstinence. We evaluated the behavioral and molecular effects of facilitating mGluR4 activity in abstinent mice.Results: Transcriptional regulation of marker genes of medium spiny neurons (MSNs) in the nucleus accumbens (NAc) allowed best discriminating between 4-week morphine and cocaine abstinence. Among these markers, Grm4, encoding mGluR4, displayed down-regulated expression in the caudate putamen and NAc of morphine, but not cocaine, abstinent mice. Remarkably, chronic administration of the mGluR4 positive allosteric modulator (PAM) VU0155041 (2.5 and 5 mg/kg) rescued social abilities, normalized stereotypies and anxiety and blunted locomotor sensitization in morphine abstinent mice. This treatment improved social preference but increased stereotypies in cocaine abstinent mice. Finally, the beneficial behavioral effects of VU0155041 treatment in morphine abstinent animals were correlated with restored expression of key MSN and neural activity marker genes in the NAc. Conclusions:This study is the first report of relieving effects of a pharmacological treatment, chronic administration of the mGluR4 PAM VU0155041, on long-term deleterious consequences of morphine exposure. It illustrates the neurobiological differences between opiate and psychostimulant abstinence and points to pharmacological repression of excessive activity of D2-MSNs in the NAc as a promising therapeutic lever in drug addiction.

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Section: Chronic Facilitation Of Mglur4 Activity Relieves Behavioral Deficits and Dampens Behavioral Sensitization In Morphine Abstinent supporting

confidence: 60%

Facilitating mGluR4 activity reverses the long-term deleterious consequences of chronic morphine exposure in male mice

Becker

Pellissier

Corde

et al. 2020

Neuropsychopharmacol.

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“…One reason is the discrepancy of what SF means and what measures best capture it. A study of SF in OUD [13] measured SF using The Social Functioning Scale, a measure designed to assess social adjustment in schizophrenia [61]. As mentioned previously, this study found worse SF in people on treatment for OUD, compared to matched controls.…”

Section: Strengths and Limitationssupporting

confidence: 52%

“…Despite SF being an important diagnostic feature, there is a dearth of research addressing SF in OUD. Only one trial to date, a small (n = 164) sampled Australian study, specifically examined SF in opioid users; data showed that, compared with matched controls, SF was significantly lower in patients receiving treatment for opioid use [13]. Studies involving other psychiatric disorders have linked impaired SF to greater drug use and depressive symptomatology [14].…”

Section: Introductionmentioning

confidence: 99%

Social functioning outcomes in men and women receiving medication-assisted treatment for opioid use disorder

et al. 2020

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Background: Social functioning (SF), the ability to engage with life and fulfill roles may be a salient "patient important outcome" in addiction treatment. It is not known if medication-assisted treatment (MAT) impacts SF in opioid use disorder (OUD). There is a growing evidence to suggest that men and women are impacted differently by OUD. This study is the largest to date to study sex differences in OUD and explore associations between MAT and SF. Methods: Data were collected from 2736 participants with OUD, enrolled in MAT for varying lengths of time, in outpatient clinics across Ontario. SF was defined according to the Maudsley Addiction Profile's domains of (1) employment, (2) criminal activity, and (3) interpersonal conflict. Using logistic regression analysis, we examined sociodemographic and clinical factors associated with domains of SF. Results: There were 1544 men (56%) and 1192 women (44%) in this study, and ages varied from 17 to 76 years for men and 18 to 69 years for women. At study entry, participants had been on MAT for a median of 2 years. Compared to men, women reported more psychological (mean MAP score 14/40, SD = 9.55, versus 11/40, SD = 8.64; p < 0.001) and physical symptoms (mean MAP score 17/40, SD = 7.70 versus 14/40, SD = 7.74; p < 0.001). More women reported unemployment(74% versus 58%; p < 0.0001) and interpersonal conflict (46% versus 35%; p < 0.0001). Men were more likely than women to report criminal activity (11%, versus 8%; p = 0.001). Psychological symptoms increased the risk of worse SF, across domains, for men and for women. Every year on MAT was associated with a 7% increase in the odds of women engaging with criminal activity (OR = 1.07, 95% CI 1.02, 1.12, p = 0.006). Conclusions: Men and women had different SF profiles and psychological symptoms scores while on MAT. The length of time on MAT increased the risk of criminal activity in women, and overall, duration of MAT was not associated with improvement in SF. This may suggest that MAT alone may not support continual improvements in SF in OUD.

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“…Despite community outreach efforts, opioid-related stigma and negative attitudes are still prevalent, and some still favor withdrawal and detox modalities despite the detrimental effects of these treatment approaches on care retention. Our stakeholder-informed evaluation con rmed that people with OUD are widely stigmatized and stereotyped (unpublished work) which can affect patient functioning [36] and whether patients seek and continue treatment [6,7]. These results emphasize a need for ongoing efforts to lower stigma, maintain open door policies for returning to treatment, and resources to maintain a patient registry and to track individuals who fall out of care, given the myriad of factors that contribute to patient success.…”

Section: Access Versus Retention In Carementioning

confidence: 80%

Outcomes from the Medication Assisted Treatment Pilot Program for Adults With Opioid Use Disorders in Rural Colorado

Amura

Sorrell

Weber

et al. 2021

Preprint

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Background. As Colorado ranked among the top nationally in non-medical use of opioids, a pilot medication for opioid use disorder (MOUD) program was developed to increase the number of NPs and PAs providing MOUD in order to bring this evidence based treatment 2 counties showing disproportionally high opioid overdose deaths. Over the first 18 months, the MOUD Pilot Program led to 15 new health care providers receiving MOUD waiver training and 1,005 patients receiving MOUD from the 3 participating organizations. Here we evaluate the impact of the pilot MOUD program implemented in 2 rural counties severely affected by the opioid crisis on patient centered clinical and functional outcomes. Methods. Under state-funded law, three rural agencies submitted patient-level data at baseline (N = 1005) and after 6 months of treatment (N = 190, 25%) between December 2017 and January 2020. The Addiction Severity Index with McNemar-Bowker and t tests were used to measure program impact. Results. Patients in treatment reported using less heroin (13.0 vs. 3.7 days), opioids (3.7 vs. 1.9 days), and alcohol (3.2 vs 0.7 days, all P < 0.01). Patients reported improved health (53.4% vs. 68.2%, P = 0.04), less days of disability (8.69 vs. 6.51, P = 0.02), symptoms (29.8% vs 21.3%), pain (67.5 % to 53.6), worry (45.3% vs 62.3%), anxiety (49.7% vs 23.2%), depression (54.1% vs 23.3%, all P < 0.02) after treatment. Conclusions. This study shows decreased substance use, improved physical and mental health, and reduced symptoms after 6 months of MOUD. Although more research on retention and long-term effects is needed, data shows improved health outcomes after 6 months of MOUD. Lessons learned from implementing this pilot program informed program expansion into other rural areas in need to address some of Colorado’ major public health crises.

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Stereotype threat and social function in opioid substitution therapy patients

Cited by 20 publications

References 63 publications

Facilitating mGluR4 activity reverses the long-term deleterious consequences of chronic morphine exposure in male mice

Facilitating mGluR4 activity reverses the long-term deleterious consequences of chronic morphine exposure in male mice

Social functioning outcomes in men and women receiving medication-assisted treatment for opioid use disorder

Outcomes from the Medication Assisted Treatment Pilot Program for Adults With Opioid Use Disorders in Rural Colorado

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