Treatment with buprenorphine linked to reduced opioid use: Study
USA: Treatment with buprenorphine-naloxone versus methadone results in a greater reduction of opioid use among adults with mental disorders and comorbid opioid use disorder (OUD), finds a recent study in the journal Addiction.
In patients with OUD, mental disorders are common, the researchers noted a need to incorporate complex factors involved in influencing outcomes of medication treatment for OUD (MOUD).
Against the above background, Yih-Ing Hser, University of California, Los Angeles, and colleagues aimed to investigate whether a reduction in opioid use differs when treated by either buprenorphine-naloxone (BUP) or methadone (MET) among adults with comorbid OUD and mental disorders.
Adults with OUD were randomized to receive either BUP or MET treatment for 24 weeks and followed up in three yearly assessments. The present secondary analyses were based on 597 participants who completed all assessments.
The outcome measures were the number of days of using opioids per month during the follow-up period. The Mini-International Neuropsychiatric Interview (MINI) was used to classify participants into three groups: Lifetime Mood Disorder (n=302), Lifetime Mental Disorder Other Than Mood Disorder (n=114), and No Mental Disorder (n=181).
A time-varying predictor was medication treatment (BUP, MET, no treatment) during the follow-up period.
Key findings of the study include:
- Based on Zero-Inflated Poisson (ZIP) mixed regression analysis, it was found that relative to no treatment, opioid use during the follow-up was significantly reduced by BUP (OR, 0.12 for any use; RR, 0.77 for days of use) and by MET (OR, 0.33 for any use; RR, 0.78 for days of use).
- Relative to MET, BUP was associated with a lower likelihood of any opioid use among participants with mood disorders (OR, 0.52) and for participants without mental disorder (OR, 0.37), and fewer number of days using opioids (RR, 0.37) among participants with other mental disorders.
The study titled, "Long-term Follow-up Assessment of Opioid Use Outcomes among Individuals with Comorbid Mental Disorders and Opioid Use Disorder Treated with Buprenorphine or Methadone in a Randomized Clinical Trial," is published in the journal Addiction.