Maintenance Treatment Strongly Associated With Opioid Abstinence

In addition to maintenance treatment, mutual-help groups can be helpful for individuals with prescription opioid dependence.

For adults with prescription opioid use disorder, both opioid agonist treatment and mutual-help group attendance improved opioid abstinence, according to results from a long-term follow-up study published in the Journal of Clinical Psychiatry.

After the Prescription Opioid Addiction Treatment Study trial, investigators led a 42-month longitudinal study from March 2009 to January 2013. At 18, 30, and 42 months after treatment entry, 338 participants (adults aged ≥18 years with prescription opioid dependence) completed telephone interviews assessing current use of pharmacotherapy, formal behavioral treatment, and mutual-help group attendance for substance use disorders (SUD).

At 18, 30, and 42 months, approximately half the participants (47%-50%) reported engaging in some form of SUD treatment. Buprenorphine maintenance was the most common current treatment (27%-35%). Current use of methadone and other SUD medications during follow-up was less common. Replacement therapy was followed by mutual-help group attendance (27%-30%) and outpatient counseling (18%-23%).

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After adjusting for opioid agonist treatment and mutual-help attendance, analyses revealed that the strongest association with opioid abstinence was current opioid agonist treatment (odds ratio, 5.4, 4.6, 2.8) and current mutual-help group attendance (odds ratio, 2.2, 2.7, 1.9) at each of the 3 times. In the adjusted models, outpatient counseling was not significantly associated with abstinence at any of the times.

Results were limited by patient participation in the follow-up study (57%) and the study’s telephone interview format, which prevented collection of urine toxicology data.

Investigators concluded, “While opioid agonist treatment was most strongly associated with opioid abstinence among patients with prescription opioid dependence over time, mutual-help group attendance was independently associated with opioid abstinence. Clinicians should consider recommending both of these interventions to patients with opioid use disorder.”

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Weiss RD, Griffin ML, Marcovitz DE, et al. Correlates of opioid abstinence in a 42-month posttreatment naturalistic follow-up study of prescription opioid dependence. J Clin Psychiatry. 2019;80(2):18m12292.

This article originally appeared on Psychiatry Advisor