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The impact of comorbid psychiatric disorders on methadone maintenance treatment in opioid use disorder: a prospective cohort study

 

Authors Rosic T, Naji L, Bawor M, Dennis BB, Plater C, Marsh DC, Thabane L, Samaan Z

Received 5 December 2016

Accepted for publication 23 February 2017

Published 24 May 2017 Volume 2017:13 Pages 1399—1408

DOI https://doi.org/10.2147/NDT.S129480

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Papan Thaipisuttikul

Peer reviewer comments 3

Editor who approved publication: Dr Roger Pinder

Objective: There is a significant interindividual variability in treatment outcomes in methadone maintenance treatment (MMT) for opioid use disorder (OUD). This prospective cohort study examines the impact of comorbid psychiatric disorders on continued illicit opioid use in patients receiving MMT for OUD.
Methods: Data were collected from 935 patients receiving MMT in outpatient clinics between June 2011 and June 2015. Using linear regression analysis, we evaluated the impact of having a comorbid psychiatric disorder on continued illicit opioid use during MMT, adjusting for important confounders. The main outcome measure was percentage of opioid-positive urine screens for 6 months. We conducted a subgroup analysis to determine the influence of specific comorbid psychiatric disorders, including substance use disorders, on continued illicit opioid use.
Results: Approximately 80% of participants had at least one comorbid psychiatric disorder in addition to OUD, and 42% of participants had a comorbid substance use disorder. There was no significant association between having a psychiatric comorbidity and continuing opioid use (=0.248). Results from subgroup analysis, however, suggest that comorbid tranquilizer (β=20.781, <0.001) and cocaine (β=6.344, =0.031) use disorders are associated with increased rates of continuing opioid use.
Conclusion: Results from our study may serve to guide future MMT guidelines. Specifically, we find that cocaine or tranquilizer use disorder, comorbid with OUD, places patients at high risk for poor MMT outcomes. Treatment centers may choose to gear more intensive therapy toward such populations.
Keywords: opioid use disorder, methadone, substance abuse, comorbidity, psychiatric disorder

 

摘要视频链接The impact of comorbid psychiatric disorders on MMT in OUD