Abarno Cristina N, Chapman Hannah M, Copeland Amy L
Department of Psychology, Louisiana State University.
Exp Clin Psychopharmacol. 2023 Apr;31(2):370-377. doi: 10.1037/pha0000599. Epub 2022 Sep 8.
Individuals with opioid use disorder (OUD) endorse high rates of combustible smoking (Zale et al., 2015) which is associated with poorer outcomes (e.g., opioid craving and lower detoxification completion rates) among individuals receiving medications for opioid use disorder (MOUD; Mannelli et al., 2013) and lower smoking cessation rates (Okoli et al., 2010). The complex pharmacological relationship between opioids and nicotine may help explain these findings (Kohut, 2017); however, little is known about psychosocial variables that influence MOUD processes among combustible smokers with OUD. The present study sought to expand upon prior work (Mannelli et al., 2013) by examining the impact of psychological factors and smoking-related variables on opioid withdrawal symptoms among smokers with OUD receiving Suboxone at an inpatient substance use treatment facility. Current smokers with OUD ( = 64) completed a battery of psychological measures examining depression, anxiety, and smoking constructs. The present study tested the influence of daily smoking rate, nicotine dependence, smoking urges, anxiety, and depression on opioid withdrawal symptoms through a hierarchical multiple regression. Findings revealed that smoking urges ( = .003) predicted severity of opioid withdrawal symptoms while controlling for race, daily smoking rate, and nicotine dependence. Depression ( = .000), however, explained variance in severity of opioid withdrawal symptoms above and beyond all smoking-related variables and anxiety. Results highlight the importance of considering psychological factors, specifically depression, which impact treatment processes among smokers with OUD to help inform the development of effective treatment interventions for both OUD and smoking cessation among individuals with OUD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
患有阿片类物质使用障碍（OUD）的个体大量吸食可燃烟草（扎莱等人，2015年），这与接受阿片类物质使用障碍药物治疗（MOUD；曼内利等人，2013年）的个体出现更差的治疗结果（如阿片类物质渴望和更低的戒毒完成率）以及更低的戒烟率（奥科利等人，2010年）有关。阿片类物质与尼古丁之间复杂的药理关系可能有助于解释这些发现（科胡特，2017年）；然而，对于影响患有OUD的可燃烟草吸烟者MOUD治疗过程的心理社会变量知之甚少。本研究试图通过考察心理因素和吸烟相关变量对在住院物质使用治疗机构接受丁丙诺啡/纳洛酮治疗的患有OUD的吸烟者阿片类物质戒断症状的影响，对先前的研究工作（曼内利等人，2013年）进行拓展。患有OUD的当前吸烟者（n = 64）完成了一系列考察抑郁、焦虑和吸烟相关构念的心理测量。本研究通过分层多元回归检验了每日吸烟率、尼古丁依赖、吸烟冲动、焦虑和抑郁对阿片类物质戒断症状的影响。研究结果显示，在控制种族、每日吸烟率和尼古丁依赖的情况下，吸烟冲动（β = .003）可预测阿片类物质戒断症状的严重程度。然而，抑郁（β = .000）在所有吸烟相关变量和焦虑之外，解释了阿片类物质戒断症状严重程度的变异。结果凸显了考虑心理因素，特别是抑郁的重要性，抑郁会影响患有OUD的吸烟者的治疗过程，有助于为针对患有OUD的个体的OUD治疗和戒烟制定有效的治疗干预措施提供信息。（《心理学文摘数据库记录》（c）2023美国心理学会，保留所有权利）
