title: Prescription drug monitoring program data tracking of opioid addiction treatment outcomes in integrated dual diagnosis care involving injectable naltrexone.
abstract: Fourfold increases in opioid prescribing and dispensations over 2 decades in the U.S. has paralleled increases in opioid addictions and overdoses, requiring new preventative, diagnostic, and treatment strategies. This study examines Prescription Drug Monitoring Program (PDMP) tracking as a novel measure of opioid addiction treatment outcomes in a university-affiliated integrated mental health-addiction treatment clinic.
  
  
  
  Repeated measure parametrics examined PDMP and urine drug screening (UDS) data before and after first injection for all patients (N = 68) who received at least one long-acting naltrexone injection (380 mg/IM) according to diagnostic groupings of having either (i) alcohol (control); (ii) opioid; or (iii) combined alcohol and opioid use disorders.
  
  
  
  There were no group differences post-injection in treatment days, injections delivered, or treatment service encounters. UDS and PDMP measures of opioid exposures were greater in opioid compared to alcohol-only patients. Post-first injection, UDS's positive for opioids declined (p < .05) along with PDMP measures of opioid prescriptions (p < .001), doses (p < .01), types (p < .001), numbers of dispensing prescribers (p < .001) and pharmacies (p < .001). Opioid patients without alcohol disorders showed the best outcomes with 50% to 80% reductions in PDMP-measures of opioids, down to levels of alcohol-only patients.
  
  
  
  This study shows PDMP utility for measuring opioid addiction treatment outcomes, supporting the routine use of PDMPs in clinical and research settings.
  
  
  
  These findings demonstrate that opioid addiction in patients with complex addictions and mental illnesses comorbidities can show effective treatment responses as measured by PDMP tracking of decreases in opioid prescriptions to those patients. (Am J Addict 2016;25:557-564).
authors.affiliation: Department of Psychiatry, Indiana University School of Medicine, Indianapoils, Indiana.
authors.forename: Ayesha
authors.initials: A
authors.lastname: Sajid
authors.affiliation: Department of Psychiatry, Indiana University School of Medicine, Indianapoils, Indiana.
authors.forename: Aaron
authors.initials: A
authors.lastname: Whiteman
authors.affiliation: Department of Psychiatry, Indiana University School of Medicine, Indianapoils, Indiana.
authors.forename: Richard L
authors.initials: RL
authors.lastname: Bell
authors.affiliation: Fairbanks School of Public Health, IUPUI, Indianapolis, Indiana.
authors.forename: Marion S
authors.initials: MS
authors.lastname: Greene
authors.affiliation: Department of Psychiatry, Indiana University School of Medicine, Indianapoils, Indiana.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Engleman
authors.affiliation: Department of Psychiatry, Indiana University School of Medicine, Indianapoils, Indiana. robchamb@iupui.edu.
authors.forename: R Andrew
authors.initials: RA
authors.lastname: Chambers
mesh_terms: D000328:Adult; D019973:Alcohol-Related Disorders / Q000150:complications; D000701:Analgesics, Opioid / Q000652:urine; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D000073958:Prescription Drug Monitoring Programs; D015813:Substance Abuse Detection; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D009292:Narcotic Antagonists; D009271:Naltrexone