Despite the growing prevalence of prescription opioid dependence, longitudinal studies have not examined long-term treatment response.
This study examined outcomes over 42 months in the CTN Prescription Opioid Abuse Treatment Study (POATS, CTN-0030) to see what, if any, improvements in abstinence from opioids was seen over a longer term.
The original POATS study was a multi-site clinical trial lasting up to 9 months, examining different durations of buprenorphine-naloxone plus standard medical management for prescription opioid dependence. A subset of participants (375 of 653) enrolled in this follow-up study.
Telephone interviews were given approximately 18, 30, and 42 months after main-trial enrollment.
Results found that
- 31.7% were abstinent from opioids and not on agonist therapy;
- 29.4% were receiving opioid agonist therapy but met no symptom criteria for current opioid dependence;
- 7.55% were using illicit opioids while on agonist therapy;
- 31.4% were using opioids without agonist therapy.
Participants reporting a lifetime history of heroin use at baseline were more likely to meet DSM-IV criteria for opioid dependence at Month 42. Engagement in agonist therapy was associated with a greater likelihood of illicit-opioid abstinence. Eight percent (27 participants) used heroin for the first time during follow-up, and 10.1% reported first-time injection heroin use.
Conclusions: This was the first study to examine long-term treatment outcomes of patients with prescription opioid dependence, and results were more encouraging than short-term outcomes from POATS suggested they might be. Long-term outcomes for those dependent on prescription opioids demonstrated clear improvement from baseline.
These data underscore the importance of longer-term follow-up in understanding the course of this increasingly prevalent substance use disorder.
Citation: Weiss RD, et al. Long-Term Outcomes from the National Drug Abuse Treatment Clinical Trial Network Prescription Opioid Study. Drug and Alcohol Dependence 2015 (in press).
Source: Clinical Trials Network Dissemination Library – March 11, 2015