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阿片类药物使用障碍的康复:一项临床研究结束 4 年后的结局研究。

Recovery from opioid use disorder: A 4-year post-clinical trial outcomes study.

机构信息

Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, 1 Riverside Circle, Roanoke, VA 24016, United States; Fralin Biomedical Research Institute at Virginia Tech Carilion, 2 Riverside Circle, Roanoke, VA 24016, United States.

Fralin Biomedical Research Institute at Virginia Tech Carilion, 2 Riverside Circle, Roanoke, VA 24016, United States; Department of Statistics, Virginia Tech, Blacksburg, VA 24061, United States.

出版信息

Drug Alcohol Depend. 2022 May 1;234:109389. doi: 10.1016/j.drugalcdep.2022.109389. Epub 2022 Mar 9.

Abstract

BACKGROUND

Opioid use disorder (OUD) seriously impacts public health in the United States. However, few investigations of long-term outcomes following treatment with medication for OUD exist. Additionally, these studies have prioritized opioid use and treatment utilization outcomes, and a gap in knowledge regarding long-term, multidimensional trajectories of OUD recovery exists. This study investigated a diverse array of outcomes for individuals with OUD at an average of 4.2 years post clinical trial participation.

METHODS

Individuals who previously participated in long-acting buprenorphine subcutaneous injection clinical trials (NCT023579011; NCT025100142; NCT02896296) and enrolled in The Remission from Chronic Opioid Use-Studying Environmental and SocioEconomic Factors on Recovery (RECOVER; NCT03604861) Study participated in a follow up assessment (n = 216). Substance use, psychosocial, opioid dependence, and delay discounting outcomes were assessed. Regression analyses were conducted to determine significant associations between psychosocial/opioid dependence variables and both recent opioid use and delay discounting.

RESULTS

The majority of participants reported abstinence from opioids since the last RECOVER study assessment (mean 2.26 years; 55%) and in the past 30 days (69%). Participants reported low levels of depression and psychological distress. Positive associations between depression and opioid craving with past 30-day opioid misuse and delay discounting, and negative associations between quality of life and treatment effectiveness with these outcomes were observed.

CONCLUSIONS

This study examined longer term OUD recovery outcomes. Participants reported high levels of abstinence from opioids and psychosocial functioning. These encouraging results highlight the multidimensional nature of recovery from OUD, and further support the effectiveness of buprenorphine as an OUD treatment.

摘要

背景

阿片类药物使用障碍(OUD)严重影响美国的公共健康。然而,针对 OUD 药物治疗后的长期结果的研究很少。此外,这些研究优先考虑了阿片类药物的使用和治疗利用结果,而对于 OUD 康复的长期、多维轨迹的知识存在差距。本研究在平均 4.2 年的临床试验参与后,调查了 OUD 患者的一系列多样化结局。

方法

先前参加过长效丁丙诺啡皮下注射临床试验(NCT023579011;NCT025100142;NCT02896296)并参加了慢性阿片类药物使用缓解研究——环境和社会经济因素对康复的影响(RECOVER;NCT03604861)研究的个体参与了后续评估(n=216)。评估了物质使用、心理社会、阿片类药物依赖和延迟折扣结果。进行回归分析以确定心理社会/阿片类药物依赖变量与近期阿片类药物使用和延迟折扣之间的显著关联。

结果

大多数参与者报告自最后一次 RECOVER 研究评估以来(平均 2.26 年;55%)和过去 30 天内(69%)已戒除阿片类药物。参与者报告的抑郁和心理困扰程度较低。观察到抑郁和阿片类药物渴求与过去 30 天内阿片类药物滥用和延迟折扣之间存在正相关,而生活质量和治疗效果与这些结果之间存在负相关。

结论

本研究检查了 OUD 康复的长期结果。参与者报告了较高水平的阿片类药物戒断和心理社会功能。这些令人鼓舞的结果突出了 OUD 康复的多维性质,并进一步支持了丁丙诺啡作为 OUD 治疗的有效性。

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