Premium
The relationship between primary prescription opioid and buprenorphine–naloxone induction outcomes in a prescription opioid dependent sample
Author(s) -
Nielsen Suzanne,
Hillhouse Maureen,
Weiss Roger D.,
Mooney Larissa,
Sharpe Potter Jennifer,
Lee Joshua,
Gourevitch Marc N.,
Ling Walter
Publication year - 2013
Publication title -
the american journal on addictions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.997
H-Index - 76
eISSN - 1521-0391
pISSN - 1055-0496
DOI - 10.1111/j.1521-0391.2013.12105.x
Subject(s) - oxycodone , opioid , medicine , hydrocodone , methadone , buprenorphine , medical prescription , opiate substitution treatment , anesthesia , (+) naloxone , addiction , morphine , psychiatry , pharmacology , receptor
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)