The impact of comorbid psychiatric disorders on methadone maintenance treatment in opioid use disorder: a prospective cohort study

Rosic, Tea; Naji, Leen; Bawor, Monica; Dennis, Brittany B.; Plater, Carolyn; Marsh, David C.; Thabane, Lehana; Samaan, Zainab

doi:10.2147/ndt.s129480

Cited by 66 publications

(61 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Clinical Determinants, Harms, and Prognosis of Co-occurring BPD and SUD While population prevalence rates for BPD are estimated to be between 1 and 6% (Trull et al, 2016;Trull, Sher, Minks-Brown, Durbin, & Burr, 2000), rates of BPD among treatment-seeking substance users are estimated to be as high as 65% (Darke, Ross, Williamson, & Teesson, 2005;Rosic et al, 2017;Trull et al, 2000). The exacerbation of symptomatology through the interaction between the disorders is of particular relevance to treatment planning as this contributes to chronicity.…”

Section: Introductionmentioning

confidence: 99%

Emotional dysregulation as a target in the treatment of co‐existing substance use and borderline personality disorders: A pilot study

Hall

Simpson

O’Donnell

et al. 2018

Clinical Psychologist

View full text Add to dashboard Cite

Background Borderline personality disorder (BPD) and substance use disorders (SUD) are frequently co‐morbid and their co‐occurrence exacerbates the symptomatology and associated harms for both disorders. However, few intervention studies have examined the delivery of an integrated intervention for BPD and SUD within alcohol and other drug (AOD) treatment settings. This single arm pilot study examined the clinical utility and outcomes of a 12‐session emotion regulation intervention for clients with co‐occurring SUD and BPD symptoms delivered in an outpatient AOD treatment setting. Method Forty‐five adult treatment‐seekers (64.4% women, mean age 35.8 years (SD = 10.4)) attending an outpatient AOD service, who exhibited three or more symptoms of BPD, engaged in a 12‐session emotion regulation intervention. Clinical measures assessing alcohol and drug use, BPD symptoms, emotion dysregulation and acceptance, non‐avoidance of thoughts and emotions, and psychological flexibility were collected at baseline, session 6 and session 12. Treatment engagement, satisfaction, and rapport were also measured. Results Fifty‐one percent of participants completed the 12‐session intervention. The results demonstrated that the number of drugs using occasions in the past 28 days significantly reduced from baseline compared to session 12. Furthermore, a significant reduction was identified in BPD symptom severity, emotion dysregulation, and non‐acceptance, experiential avoidance, and psychological inflexibility from baseline to session 12. Conclusions For those individuals who completed the 12‐session emotion regulation intervention, there were significant reductions across a number of clinical outcomes. However, retention in treatment for this vulnerable client group remains a significant challenge in the AOD setting.

show abstract

Section: Introductionmentioning

confidence: 99%

Emotional dysregulation as a target in the treatment of co‐existing substance use and borderline personality disorders: A pilot study

Hall

Simpson

O’Donnell

et al. 2018

Clinical Psychologist

View full text Add to dashboard Cite

show abstract

“…Participants also underwent a structured clinical interview, administered by trained research staff, and provided urine and blood samples. Please see previous literature for a more thorough description of GENOA methodology [31,32]. The POST study began in 2018 as an extension to GENOA, with similar data collection protocol and inclusion criteria, barring participants now meeting criteria for OUD as diagnosed with the DSM-5 [12].…”

Section: Datamentioning

confidence: 99%

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

et al. 2020

Self Cite

View full text Add to dashboard Cite

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.

show abstract

“…[7][8][9][15][16][17][18] Logistic regression models have been developed to predict patients who may be susceptible to prescription opioid abuse. [7][8][9] Comorbid psychiatric disorders have been considered for their impact on the efficacy of various treatments of opioid use disorder, [15] and literature reviews have found high rates of co-occurrence between opioid use disorder and anxiety, psychiatric comorbidity, and drug use. [16][17][18] These studies focus on either city-level spatiotemporal patterns, and/or solely on abuse of a single class of opioids.…”

Section: Introductionmentioning

confidence: 99%

Comprehensive Spatiotemporal Analysis of Opioid Poisoning Mortality in Ohio from 2010 to 2016

Park

Clemenceau

Seballos

et al. 2019

Preprint

View full text Add to dashboard Cite

Objective: We aimed to identify (1) differences in opioid poisoning mortality among population groups, (2) geographic clusters of opioid-related deaths over time, and (3) health conditions co-occurring with opioid-related death in Ohio by computational analysis. Materials and Methods: We used a large-scale Ohio vital statistic dataset from the Ohio Department of Health (ODH) and U.S. Census data from 2010-2016. We surveyed population differences with demographic profiling and use of relative proportions, conducted spatiotemporal pattern analysis with spatial autocorrelation via Moran statistics at the census tract level, and performed comorbidity analysis using frequent itemset mining and association rule mining. Results: Our analyses found higher rates of opioid-related death in people aged 25-54, whites, and males. We also found that opioid-related deaths in Ohio became more spatially concentrated during 2010-2016, and tended to be most clustered around Cleveland, Columbus and Cincinnati. Drug abuse, anxiety and cardiovascular disease were found to predict opioid-related death. Discussion: Comprehensive data-driven spatiotemporal analysis of opioid-related deaths provides essential identification of demographic, geographic and health factors related to opioid abuse. Future research should access personal health information for more detailed comorbidity analysis, as well as expand spatiotemporal models for real-time use. Conclusion: Computational analyses revealed demographic differences in opioid poisoning, changing regional patterns of opioid-related deaths, and health conditions co-occurring with opioid overdose for Ohio from 2010-2016, providing essential knowledge for both government officials and caregivers to establish policies and strategies to best combat the opioid epidemic.

show abstract

The impact of comorbid psychiatric disorders on methadone maintenance treatment in opioid use disorder: a prospective cohort study

Cited by 66 publications

References 61 publications

Emotional dysregulation as a target in the treatment of co‐existing substance use and borderline personality disorders: A pilot study

Emotional dysregulation as a target in the treatment of co‐existing substance use and borderline personality disorders: A pilot study

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

Comprehensive Spatiotemporal Analysis of Opioid Poisoning Mortality in Ohio from 2010 to 2016

Contact Info

Product

Resources

About