title: Long-term outcomes from the National Drug Abuse Treatment Clinical Trials Network Prescription Opioid Addiction Treatment Study.
abstract: BACKGROUND
  Despite the growing prevalence of prescription opioid dependence, longitudinal studies have not examined long-term treatment response. The current study examined outcomes over 42 months in the Prescription Opioid Addiction Treatment Study (POATS).
  
  
  METHODS
  POATS was a multi-site clinical trial lasting up to 9 months, examining different durations of buprenorphine-naloxone plus standard medical management for prescription opioid dependence, with participants randomized to receive or not receive additional opioid drug counseling. A subset of participants (N=375 of 653) enrolled in a follow-up study. Telephone interviews were administered approximately 18, 30, and 42 months after main-trial enrollment. Comparison of baseline characteristics by follow-up participation suggested few differences.
  
  
  RESULTS
  At Month 42, much improvement was seen: 31.7% were abstinent from opioids and not on agonist therapy; 29.4% were receiving opioid agonist therapy, but met no symptom criteria for current opioid dependence; 7.5% were using illicit opioids while on agonist therapy; and the remaining 31.4% were using opioids without agonist therapy. Participants reporting a lifetime history of heroin use at baseline were more likely to meet DSM-IV criteria for opioid dependence at Month 42 (OR=4.56, 95% CI=1.29-16.04, p<.05). Engagement in agonist therapy was associated with a greater likelihood of illicit-opioid abstinence. Eight percent (n=27/338) used heroin for the first time during follow-up; 10.1% reported first-time injection heroin use.
  
  
  CONCLUSIONS
  Long-term outcomes for those dependent on prescription opioids demonstrated clear improvement from baseline. However, a subset exhibited a worsening course, by initiating heroin use and/or injection opioid use.
authors.affiliation: McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA. Electronic address: rweiss@mclean.harvard.edu.
authors.forename: Roger D
authors.initials: RD
authors.lastname: Weiss
authors.affiliation: McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.
authors.forename: Jennifer Sharpe
authors.initials: JS
authors.lastname: Potter
authors.affiliation: McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Griffin
authors.affiliation: McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA.
authors.forename: Scott E
authors.initials: SE
authors.lastname: Provost
authors.affiliation: McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Department of Biostatistics, Harvard School of Public Health, 677 Huntington Street, Boston, MA 02115, USA.
authors.forename: Garrett M
authors.initials: GM
authors.lastname: Fitzmaurice
authors.affiliation: McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: McDermott
authors.affiliation: McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA.
authors.forename: Emily N
authors.initials: EN
authors.lastname: Srisarajivakul
authors.affiliation: McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA.
authors.forename: Dorian R
authors.initials: DR
authors.lastname: Dodd
authors.affiliation: McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Dreifuss
authors.affiliation: McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
authors.forename: R Kathryn
authors.initials: RK
authors.lastname: McHugh
authors.affiliation: Department of Psychiatry, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Carroll
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D016739:Behavior, Addictive / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D003376:Counseling; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid
keywords: Addiction; Follow-up; Heroin; Opioids; Prescription opioids; Treatment
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