The relationship between primary prescription opioid and buprenorphine-naloxone induction outcomes in a prescription opioid dependent sample

Suzanne Nielsen, Maureen Hillhouse, Roger D. Weiss, Larissa Mooney, Jennifer Sharpe Potter, Joshua Lee, Marc Gourevitch, Walter Ling

Research output: Contribution to journalArticle

Abstract

Background and objectives This analysis aims to: (1) compare induction experiences among participants who self-reported using one of the four most commonly reported POs, and (2) examine factors associated with difficult bup-nx induction. Our hypothesis, based on previous research and current guidelines, is that those on longer-acting opioids will have experienced more difficult inductions. Methods The Prescription Opioid Addiction Treatment Study (POATS) was a multi-site, randomized clinical trial, using a two-phase adaptive treatment research design. This analysis examines bup-nx induction of participants who self-reported primary PO use of methadone, ER-oxycodone, IR-oxycodone, and hydrocodone (n-=-569). Analyses examined characteristics associated with difficult induction, defined as increased withdrawal symptoms measured by the Clinical Opiate Withdrawal Scale (COWS) after the first bup-nx dose with higher scores denoting greater withdrawal symptoms/severity. Results Contrary to our hypothesis, difficult induction experiences did not differ by primary PO type. Those who experienced a post-induction increase in COWS score had lower pre-dose COWS scores compared to those who did not experience a post-induction increase in COWS score (10.09 vs. 12.77, t(624)-=-13.56, p-<-.001). Demographics characteristics, depression, and pain history did not predict a difficult induction. Conclusions and scientific significance Difficult bup-nx inductions were not associated with participants' primary PO. Severity of withdrawal, measured with the COWS, was an important variable, reminding clinicians that bup-nx should not be commenced prior to evidence of moderate opioid withdrawal. These findings add to the evidence that with careful procedures, bup-nx can used with few difficulties in PO-dependent patients. (Am J Addict 2014;23:343-348)

Original languageEnglish (US)
Pages (from-to)343-348
Number of pages6
JournalAmerican Journal on Addictions
Volume23
Issue number4
DOIs
StatePublished - 2014

Fingerprint

Opiate Alkaloids
Opioid Analgesics
Prescriptions
Oxycodone
Substance Withdrawal Syndrome
Hydrocodone
Methadone
Research Design
Randomized Controlled Trials
Demography
Naloxone Drug Combination Buprenorphine
Guidelines
Depression
Pain
Therapeutics
Research

Keywords

  • buprenorphine
  • induction
  • prescription opioid dependence

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Psychiatry and Mental health
  • Clinical Psychology
  • Medicine(all)

Cite this

The relationship between primary prescription opioid and buprenorphine-naloxone induction outcomes in a prescription opioid dependent sample. / Nielsen, Suzanne; Hillhouse, Maureen; Weiss, Roger D.; Mooney, Larissa; Sharpe Potter, Jennifer; Lee, Joshua; Gourevitch, Marc; Ling, Walter.

In: American Journal on Addictions, Vol. 23, No. 4, 2014, p. 343-348.

Research output: Contribution to journalArticle

Nielsen, Suzanne ; Hillhouse, Maureen ; Weiss, Roger D. ; Mooney, Larissa ; Sharpe Potter, Jennifer ; Lee, Joshua ; Gourevitch, Marc ; Ling, Walter. / The relationship between primary prescription opioid and buprenorphine-naloxone induction outcomes in a prescription opioid dependent sample. In: American Journal on Addictions. 2014 ; Vol. 23, No. 4. pp. 343-348.
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