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Randomized Controlled Trial
. 2022;57(11):1732-1742.
doi: 10.1080/10826084.2022.2112230. Epub 2022 Aug 17.

Patient Characteristics Associated with Opioid Abstinence after Participation in a Trial of Buprenorphine versus Injectable Naltrexone

Affiliations
Randomized Controlled Trial

Patient Characteristics Associated with Opioid Abstinence after Participation in a Trial of Buprenorphine versus Injectable Naltrexone

Miranda G Greiner et al. Subst Use Misuse. 2022.

Abstract

Background and Objectives: Better understanding of predictors of opioid abstinence among patients with opioid use disorder (OUD) may help to inform interventions and personalize treatment plans. This analysis examined patient characteristics associated with opioid abstinence in the X:BOT (Extended-Release Naltrexone versus Buprenorphine for Opioid Treatment) trial. Methods: This post-hoc analysis examined factors associated with past-month opioid abstinence at the 36-week follow-up visit among participants in the X:BOT study. 428 participants (75% of original sample) attended the visit at 36 weeks. Logistic regression models were used to estimate the probability of opioid abstinence across various baseline sociodemographics, clinical characteristics, and treatment variables. Results: Of the 428 participants, 143 (33%) reported abstinence from non-prescribed opioids at the 36-week follow-up. Participants were more likely to be opioid abstinent if randomized to XR-NTX (compared to BUP-NX), were on XR-NTX at week 36 (compared to those off OUD pharmacotherapy), successfully inducted onto either study medication, had longer time on study medication, reported a greater number of abstinent weeks, or had longer time to relapse during the 24-week treatment trial. Participants were less likely to be abstinent if Hispanic, had a severe baseline Hamilton Depression Rating (HAM-D) score, or had baseline sedative use. Conclusions: A substantial proportion of participants was available at follow-up (75%), was on OUD pharmacotherapy (53%), and reported past-month opioid abstinence (33%) at 36 weeks. A minority of patients off medication for OUD reported abstinence and additional research is needed exploring patient characteristics that may be associated with successful treatment outcomes.

Keywords: Opioid abstinence; buprenorphine; extended-release injectable naltrexone; opioid use disorder.

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Figures

Figure 1.
Figure 1.
Factors significantly associated with past-month opioid abstinence at week 36.* *Odds ratios are presented on the x-axis with a log scale. 95% confidence intervals are shown for odds ratios. Abbreviations: XR-NTX=extended-release injectable naltrexone; BUP-NX=buprenorphine-naloxone; MOUD=medication for opioid use disorder; HAM-D=Hamilton Rating Depression Scale

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