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. 2017 Oct-Dec;38(4):389-393.
doi: 10.1080/08897077.2017.1353570. Epub 2017 Jul 10.

Overdose history is associated with postdetoxification treatment preference for persons with opioid use disorder

Michael D Stein  1   2 , Jessica N Flori  1 , Megan M Risi  1 , Micah T Conti  1 , Bradley J Anderson  1 , Genie L Bailey  2   3
Affiliations

Overdose history is associated with postdetoxification treatment preference for persons with opioid use disorder

Michael D Stein et al. Subst Abus. 2017 Oct-Dec.

Abstract

Background: Without aftercare treatment, persons discharged from short-term inpatient detoxification for opioid use disorder are at high risk of relapse. In previous work, those who were recently homeless or had pending legal problems were more likely to prefer residential treatment for aftercare. Here, based on clinical experience, the authors hypothesize that a particular clinical factor, surviving an opioid overdose, will be associated with aftercare preference.

Methods: Between May and December 2015, the authors surveyed consecutive persons seeking inpatient opioid detoxification. To assess aftercare treatment preference, participants were asked, "If you had unlimited treatment options and all were free, which one would work best for you when you leave here?" To assess overdose history, participants were asked about overdose "since your first drug use," and "in the last year."

Results: Participants' (N = 440) mean age was 32.3 (± 8.7) years; 70.7% were male. More than half (51.1%) of participants expressed an aftercare preference for medication-assisted treatment (MAT), 12.7% for outpatient counseling only, 10.7% for residential treatment,18.6% for no formal treatment (Narcotics Anonymous/Alcoholics Anonymous only or a halfway house), and 6.8% did not want any postdetoxification treatment. About 40% reported a history of overdose, and 24.8% reported past year overdose. In the multivariate model, treatment preference was associated with sex (P < .001), homelessness (P = .01), and history of drug overdose (P = .02).

Conclusions: Although MAT was preferred by the majority of participants, the experience of a nonfatal overdose was associated with the choice of residential treatment as postdetoxification treatment.

Trial registration: ClinicalTrials.gov NCT01751789.

Keywords: Detoxification; opioids; overdose; residential treatment.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

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