Correlates of cocaine use during methadone treatment: implications for screening and clinical management (ANRS Methaville study)

doi:10.1186/s12954-016-0100-7

Randomized Controlled Trial

. 2016 Apr 5:13:12.

doi: 10.1186/s12954-016-0100-7.

Correlates of cocaine use during methadone treatment: implications for screening and clinical management (ANRS Methaville study)

Perrine Roux^{1

2

3}, Caroline Lions^{4

5

6}, Antoine Vilotitch^{4

5

6}, Laurent Michel^{7

8

9}, Marion Mora^{4

5

6}, Gwenaelle Maradan^{4

5

6}, Fabienne Marcellin^{4

5

6}, Bruno Spire^{4

5

6}, Alain Morel¹⁰, Patrizia M Carrieri^{4

5

6}; ANRS Methaville study group

Collaborators, Affiliations

Collaborators

ANRS Methaville study group:
P M Carrieri, A Morel, L Michel, M Mora, P Roux, J F Aubertin, S Robinet, J P Daulouede, J C Desenclos, J Cohen, A Herszkowicz, C Paul, I Porteret, T Sainte Marie, J Bachellier, P Beauverie, J P Couteron, C Marty-Double, M Vray, R Baker, H Catania, M Gossop, R Haemmig, M Torrens, A Wodak, Carrieri L Michel, M Mora, P Roux, G Maradan, J Biemar, S Huguet, P Kurkdji, C Taieb, J Cohen, C Giovannini, M P Kissikian, J C Desenclos, N Job-Spira, V Dore, C Paul, I Porteret, N Richard, A Herszkowicz, N Prisse, F Olivet, J Arditti

Affiliations

¹ INSERM, UMR_S 912, Sciences Economiques & Sociales de la Santé et Traitement de l'Information Médicale (SESSTIM), 27 bd Jean Moulin, 13385, Marseille, France. perrine.roux@inserm.fr.
² Aix Marseille Université, UMR_S 912, IRD, Marseille, France. perrine.roux@inserm.fr.
³ ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France. perrine.roux@inserm.fr.
⁴ INSERM, UMR_S 912, Sciences Economiques & Sociales de la Santé et Traitement de l'Information Médicale (SESSTIM), 27 bd Jean Moulin, 13385, Marseille, France.
⁵ Aix Marseille Université, UMR_S 912, IRD, Marseille, France.
⁶ ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France.
⁷ INSERM, Research Unit 669, Paris, France.
⁸ Univ Paris-Sud and Univ Paris Descartes, UMR-S0669, Paris, France.
⁹ Centre Pierre Nicole, Paris, France.
¹⁰ Oppelia, Paris, France.

PMID: 27048152
PMCID: PMC4822310
DOI: 10.1186/s12954-016-0100-7

Randomized Controlled Trial

Correlates of cocaine use during methadone treatment: implications for screening and clinical management (ANRS Methaville study)

Perrine Roux et al. Harm Reduct J. 2016.

. 2016 Apr 5:13:12.

doi: 10.1186/s12954-016-0100-7.

Authors

Collaborators

ANRS Methaville study group:
P M Carrieri, A Morel, L Michel, M Mora, P Roux, J F Aubertin, S Robinet, J P Daulouede, J C Desenclos, J Cohen, A Herszkowicz, C Paul, I Porteret, T Sainte Marie, J Bachellier, P Beauverie, J P Couteron, C Marty-Double, M Vray, R Baker, H Catania, M Gossop, R Haemmig, M Torrens, A Wodak, Carrieri L Michel, M Mora, P Roux, G Maradan, J Biemar, S Huguet, P Kurkdji, C Taieb, J Cohen, C Giovannini, M P Kissikian, J C Desenclos, N Job-Spira, V Dore, C Paul, I Porteret, N Richard, A Herszkowicz, N Prisse, F Olivet, J Arditti

Affiliations

¹ INSERM, UMR_S 912, Sciences Economiques & Sociales de la Santé et Traitement de l'Information Médicale (SESSTIM), 27 bd Jean Moulin, 13385, Marseille, France. perrine.roux@inserm.fr.
² Aix Marseille Université, UMR_S 912, IRD, Marseille, France. perrine.roux@inserm.fr.
³ ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France. perrine.roux@inserm.fr.
⁴ INSERM, UMR_S 912, Sciences Economiques & Sociales de la Santé et Traitement de l'Information Médicale (SESSTIM), 27 bd Jean Moulin, 13385, Marseille, France.
⁵ Aix Marseille Université, UMR_S 912, IRD, Marseille, France.
⁶ ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France.
⁷ INSERM, Research Unit 669, Paris, France.
⁸ Univ Paris-Sud and Univ Paris Descartes, UMR-S0669, Paris, France.
⁹ Centre Pierre Nicole, Paris, France.
¹⁰ Oppelia, Paris, France.

PMID: 27048152
PMCID: PMC4822310
DOI: 10.1186/s12954-016-0100-7

Abstract

Background: Cocaine use is frequent in patients receiving methadone maintenance treatment (MMT) and can jeopardize their treatment response. Identifying clinical predictors of cocaine use during methadone treatment can potentially improve clinical management. We used longitudinal data from the ANRS Methaville trial both to describe self-reported occasional and regular cocaine use during MMT and to identify clinical predictors.

Methods: We selected 183 patients who had data on cocaine (or crack) use at months 0 (M0), M6, and/or M12, accounting for 483 visits. The outcome was "cocaine use" in three categories: "no," "occasional," and "regular" use. To identify factors associated with the outcome over time, we performed a mixed multinomial logistic regression.

Results: Time on methadone was significantly associated with a decrease in occasional but not in regular cocaine use from 14.7% at M0 to 7.1% at M12, and from 10.7% at baseline to 6.5% at M12, respectively. After multiple adjustments, opiate injection, individuals screening positive for attention deficit hyperactivity disorder (ADHD) symptoms, and those presenting depressive symptoms were more likely to regularly use cocaine.

Conclusions: Although time on MMT had a positive impact on occasional cocaine use, it had no impact on regular cocaine use. Moreover, regular cocaine users were more likely to report opiate injection and to present ADHD and depressive symptoms. Early screening of these disorders and prompt tailored pharmacological and behavioral interventions can potentially reduce cocaine use and improve response to MMT.

Trial registration: The trial is registered with the French Agency of Pharmaceutical Products (AFSSAPS) under the number 2008-A0277-48, the European Union Drug Regulating Authorities Clinical Trials, number Eudract 2008-001338-28, the ClinicalTrials.gov Identifier: NCT00657397 , and the International Standard Randomised Controlled Trial Number Register ISRCTN31125511.

Keywords: ADHD; Cocaine; Depression; Injection; Maintenance; Methadone; Opioid dependence.

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Figures

**Fig. 1**
Cocaine use in methadone patients: M0, M6, and M12 visits

See this image and copyright information in PMC

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References

1. Connock M, Juarez-Garcia A, Jowett S, Frew E, Liu Z, Taylor RJ, et al. Methadone and buprenorphine for the management of opioid dependence: a systematic review and economic evaluation. Health Technol Assess. 2007;11(9):1–171. doi: 10.3310/hta11090. - DOI - PubMed
1. Magura S, Kang SY, Nwakeze PC, Demsky S. Temporal patterns of heroin and cocaine use among methadone patients. Subst Use Misuse. 1998;33(12):2441–67. doi: 10.3109/10826089809059334. - DOI - PubMed
1. Savant JD, Barry DT, Cutter CJ, Joy MT, Dinh A, Schottenfeld RS et al. Prevalence of mood and substance use disorders among patients seeking primary care office-based buprenorphine/naloxone treatment. Drug Alcohol Depend. 2012. doi:10.1016/j.drugalcdep.2012.06.020. - PMC - PubMed
1. Hubbard RL, Craddock SG, Anderson J. Overview of 5-year followup outcomes in the drug abuse treatment outcome studies (DATOS) J Subst Abuse Treat. 2003;25(3):125–34. doi: 10.1016/S0740-5472(03)00130-2. - DOI - PubMed
1. Senbanjo R, Wolff K, Marshall EJ, Strang J. Persistence of heroin use despite methadone treatment: poor coping self-efficacy predicts continued heroin use. Drug Alcohol Rev. 2009;28(6):608–15. doi: 10.1111/j.1465-3362.2009.00064.x. - DOI - PubMed

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[1] Connock M, Juarez-Garcia A, Jowett S, Frew E, Liu Z, Taylor RJ, et al. Methadone and buprenorphine for the management of opioid dependence: a systematic review and economic evaluation. Health Technol Assess. 2007;11(9):1–171. doi: 10.3310/hta11090. - DOI - PubMed

[2] Connock M, Juarez-Garcia A, Jowett S, Frew E, Liu Z, Taylor RJ, et al. Methadone and buprenorphine for the management of opioid dependence: a systematic review and economic evaluation. Health Technol Assess. 2007;11(9):1–171. doi: 10.3310/hta11090. - DOI - PubMed

[3] Magura S, Kang SY, Nwakeze PC, Demsky S. Temporal patterns of heroin and cocaine use among methadone patients. Subst Use Misuse. 1998;33(12):2441–67. doi: 10.3109/10826089809059334. - DOI - PubMed

[4] Magura S, Kang SY, Nwakeze PC, Demsky S. Temporal patterns of heroin and cocaine use among methadone patients. Subst Use Misuse. 1998;33(12):2441–67. doi: 10.3109/10826089809059334. - DOI - PubMed

[5] Savant JD, Barry DT, Cutter CJ, Joy MT, Dinh A, Schottenfeld RS et al. Prevalence of mood and substance use disorders among patients seeking primary care office-based buprenorphine/naloxone treatment. Drug Alcohol Depend. 2012. doi:10.1016/j.drugalcdep.2012.06.020. - PMC - PubMed

[6] Savant JD, Barry DT, Cutter CJ, Joy MT, Dinh A, Schottenfeld RS et al. Prevalence of mood and substance use disorders among patients seeking primary care office-based buprenorphine/naloxone treatment. Drug Alcohol Depend. 2012. doi:10.1016/j.drugalcdep.2012.06.020. - PMC - PubMed

[7] Hubbard RL, Craddock SG, Anderson J. Overview of 5-year followup outcomes in the drug abuse treatment outcome studies (DATOS) J Subst Abuse Treat. 2003;25(3):125–34. doi: 10.1016/S0740-5472(03)00130-2. - DOI - PubMed

[8] Hubbard RL, Craddock SG, Anderson J. Overview of 5-year followup outcomes in the drug abuse treatment outcome studies (DATOS) J Subst Abuse Treat. 2003;25(3):125–34. doi: 10.1016/S0740-5472(03)00130-2. - DOI - PubMed

[9] Senbanjo R, Wolff K, Marshall EJ, Strang J. Persistence of heroin use despite methadone treatment: poor coping self-efficacy predicts continued heroin use. Drug Alcohol Rev. 2009;28(6):608–15. doi: 10.1111/j.1465-3362.2009.00064.x. - DOI - PubMed

[10] Senbanjo R, Wolff K, Marshall EJ, Strang J. Persistence of heroin use despite methadone treatment: poor coping self-efficacy predicts continued heroin use. Drug Alcohol Rev. 2009;28(6):608–15. doi: 10.1111/j.1465-3362.2009.00064.x. - DOI - PubMed

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Correlates of cocaine use during methadone treatment: implications for screening and clinical management (ANRS Methaville study)

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Correlates of cocaine use during methadone treatment: implications for screening and clinical management (ANRS Methaville study)

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