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

Tea Rosic,1 Leen Naji,2 Monica Bawor,3 Brittany B Dennis,3 Carolyn Plater,4 David C Marsh,5 Lehana Thabane,6–8 Zainab Samaan6–11 1St Joseph’s Healthcare, 2Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada; 3St George’s Universit...

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Autores principales:	Rosic T, Naji L, Bawor M, Dennis BB, Plater C, Marsh DC, Thabane L, Samaan Z
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	opioid use disorder methadone substance abuse comorbidity psychiatric disorder Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/0b644bdf51084b74860ef3838726d9dc
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spelling	oai:doaj.org-article:0b644bdf51084b74860ef3838726d9dc2021-12-02T05:07:58ZThe impact of comorbid psychiatric disorders on methadone maintenance treatment in opioid use disorder: a prospective cohort study1178-2021https://doaj.org/article/0b644bdf51084b74860ef3838726d9dc2017-05-01T00:00:00Zhttps://www.dovepress.com/the-impact-of-comorbid-psychiatric-disorders-on-methadone-maintenance--peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Tea Rosic,1 Leen Naji,2 Monica Bawor,3 Brittany B Dennis,3 Carolyn Plater,4 David C Marsh,5 Lehana Thabane,6–8 Zainab Samaan6–11 1St Joseph’s Healthcare, 2Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada; 3St George’s University of London, London, UK; 4Canadian Addiction Treatment Centre, Richmond Hill, 5Northern Ontario School of Medicine, Sudbury, 6Biostatistics Unit, Research Institute, St Joseph’s Healthcare, 7Department of Clinical Epidemiology and Biostatistics, McMaster University, 8Peter Boris Centre for Addictions Research, 9Mood Disorders Research Unit, St Joseph’s Healthcare, 10Population Genomics Program, Chanchlani Research Centre, 11Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada 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 (P=0.248). Results from subgroup analysis, however, suggest that comorbid tranquilizer (β=20.781, P<0.001) and cocaine (β=6.344, P=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 disorderRosic TNaji LBawor MDennis BBPlater CMarsh DCThabane LSamaan ZDove Medical Pressarticleopioid use disordermethadonesubstance abusecomorbiditypsychiatric disorderNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 13, Pp 1399-1408 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	opioid use disorder methadone substance abuse comorbidity psychiatric disorder Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	opioid use disorder methadone substance abuse comorbidity psychiatric disorder Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Rosic T Naji L Bawor M Dennis BB Plater C Marsh DC Thabane L Samaan Z The impact of comorbid psychiatric disorders on methadone maintenance treatment in opioid use disorder: a prospective cohort study
description	Tea Rosic,1 Leen Naji,2 Monica Bawor,3 Brittany B Dennis,3 Carolyn Plater,4 David C Marsh,5 Lehana Thabane,6–8 Zainab Samaan6–11 1St Joseph’s Healthcare, 2Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada; 3St George’s University of London, London, UK; 4Canadian Addiction Treatment Centre, Richmond Hill, 5Northern Ontario School of Medicine, Sudbury, 6Biostatistics Unit, Research Institute, St Joseph’s Healthcare, 7Department of Clinical Epidemiology and Biostatistics, McMaster University, 8Peter Boris Centre for Addictions Research, 9Mood Disorders Research Unit, St Joseph’s Healthcare, 10Population Genomics Program, Chanchlani Research Centre, 11Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada 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 (P=0.248). Results from subgroup analysis, however, suggest that comorbid tranquilizer (β=20.781, P<0.001) and cocaine (β=6.344, P=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
format	article
author	Rosic T Naji L Bawor M Dennis BB Plater C Marsh DC Thabane L Samaan Z
author_facet	Rosic T Naji L Bawor M Dennis BB Plater C Marsh DC Thabane L Samaan Z
author_sort	Rosic T
title	The impact of comorbid psychiatric disorders on methadone maintenance treatment in opioid use disorder: a prospective cohort study
title_short	The impact of comorbid psychiatric disorders on methadone maintenance treatment in opioid use disorder: a prospective cohort study
title_full	The impact of comorbid psychiatric disorders on methadone maintenance treatment in opioid use disorder: a prospective cohort study
title_fullStr	The impact of comorbid psychiatric disorders on methadone maintenance treatment in opioid use disorder: a prospective cohort study
title_full_unstemmed	The impact of comorbid psychiatric disorders on methadone maintenance treatment in opioid use disorder: a prospective cohort study
title_sort	impact of comorbid psychiatric disorders on methadone maintenance treatment in opioid use disorder: a prospective cohort study
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/0b644bdf51084b74860ef3838726d9dc
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The impact of comorbid psychiatric disorders on methadone maintenance treatment in opioid use disorder: a prospective cohort study

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