Randomized Controlled Trial

. 2023 Jun:149:209031.

doi: 10.1016/j.josat.2023.209031. Epub 2023 Mar 30.

Differential effect of cannabis use on opioid agonist treatment outcomes: Exploratory analyses from the OPTIMA study

Collaborators, Affiliations

Collaborators

OPTIMA Research Group within the Canadian Research Initiative in Substance Misuse:
Susan Bornemisza, Helen Bouman, Sarah Elliott, Laura Evans, Monty Ghosh, Lucas Gursky, Lydia Vezina, Cam Wild, Alvis Yu, Keith Ahamad, Paxton Bach, Rupinder Brar, Nadia Fairbairn, Christopher Fairgrieve, Sonia Habibian, Sukhpreet Klaire, Scott MacDonald, Mark McLean, Seonaid Christine Nolan, Gerrit Prinsloo, Christy Sutherland, Evan Wood, Nikki Bozinoff, Benedikt Fischer, Mike Franklin, Ahmed Hassan, Dafna Kahana, Dina Lagzdins, David Marsh, Jürgen Rehm, David Barbeau, Julie Bruneau, Sidney Maynard, Annie Talbot, Louis-Christophe Juteau

Affiliations

¹ Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, 2900 boul. Edouard-Montpetit, Montréal, Québec H3T 1J4, Canada; Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 Saint-Denis Street, Montréal, Québec H2X 0A9, Canada.
² Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 Saint-Denis Street, Montréal, Québec H2X 0A9, Canada.
³ British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, British Columbia V6Z 2A9, Canada; Department of Medicine, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, British Columbia V5Z 1M9, Canada.
⁴ Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada; Department of Pharmacology and Toxicology, Faculty of Medicine, Medical Sciences Building, University of Toronto, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada; Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, 500 University Avenue, 5th floor, Toronto, Ontario M5G 1V7, Canada; Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, Ontario M5T 1R8, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M7, Canada; Waypoint Research Institute, Waypoint Centre for Mental Health Care, 500 Church Street, Penetanguishene, Ontario L9M 1G3, Canada.
⁵ Department of Medicine and Psychiatry, Cumming School of Medicine, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 1N4, Canada.
⁶ Unité de recherche clinique appliquée, Centre hospitalier universitaire Ste-Justine, 3175 chemin de la Côte Ste-Catherine, Montréal, Québec H3T 1C5, Canada.
⁷ Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 Saint-Denis Street, Montréal, Québec H2X 0A9, Canada; Department of Family and Emergency Medicine, Faculty of Medicine, Université de Montréal, 2900 boul. Edouard-Montpetit, Montréal, Québec H3T 1J4, Canada.
⁸ Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, 2900 boul. Edouard-Montpetit, Montréal, Québec H3T 1J4, Canada; Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 Saint-Denis Street, Montréal, Québec H2X 0A9, Canada. Electronic address: didier.jutras-aswad@umontreal.ca.

PMID: 37003540
DOI: 10.1016/j.josat.2023.209031

Free article

Randomized Controlled Trial

Differential effect of cannabis use on opioid agonist treatment outcomes: Exploratory analyses from the OPTIMA study

Laurent Elkrief et al. J Subst Use Addict Treat. 2023 Jun.

Free article

. 2023 Jun:149:209031.

doi: 10.1016/j.josat.2023.209031. Epub 2023 Mar 30.

Collaborators

OPTIMA Research Group within the Canadian Research Initiative in Substance Misuse:
Susan Bornemisza, Helen Bouman, Sarah Elliott, Laura Evans, Monty Ghosh, Lucas Gursky, Lydia Vezina, Cam Wild, Alvis Yu, Keith Ahamad, Paxton Bach, Rupinder Brar, Nadia Fairbairn, Christopher Fairgrieve, Sonia Habibian, Sukhpreet Klaire, Scott MacDonald, Mark McLean, Seonaid Christine Nolan, Gerrit Prinsloo, Christy Sutherland, Evan Wood, Nikki Bozinoff, Benedikt Fischer, Mike Franklin, Ahmed Hassan, Dafna Kahana, Dina Lagzdins, David Marsh, Jürgen Rehm, David Barbeau, Julie Bruneau, Sidney Maynard, Annie Talbot, Louis-Christophe Juteau

Affiliations

¹ Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, 2900 boul. Edouard-Montpetit, Montréal, Québec H3T 1J4, Canada; Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 Saint-Denis Street, Montréal, Québec H2X 0A9, Canada.
² Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 Saint-Denis Street, Montréal, Québec H2X 0A9, Canada.
³ British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, British Columbia V6Z 2A9, Canada; Department of Medicine, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, British Columbia V5Z 1M9, Canada.
⁴ Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada; Department of Pharmacology and Toxicology, Faculty of Medicine, Medical Sciences Building, University of Toronto, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada; Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, 500 University Avenue, 5th floor, Toronto, Ontario M5G 1V7, Canada; Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, Ontario M5T 1R8, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M7, Canada; Waypoint Research Institute, Waypoint Centre for Mental Health Care, 500 Church Street, Penetanguishene, Ontario L9M 1G3, Canada.
⁵ Department of Medicine and Psychiatry, Cumming School of Medicine, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 1N4, Canada.
⁶ Unité de recherche clinique appliquée, Centre hospitalier universitaire Ste-Justine, 3175 chemin de la Côte Ste-Catherine, Montréal, Québec H3T 1C5, Canada.
⁷ Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 Saint-Denis Street, Montréal, Québec H2X 0A9, Canada; Department of Family and Emergency Medicine, Faculty of Medicine, Université de Montréal, 2900 boul. Edouard-Montpetit, Montréal, Québec H3T 1J4, Canada.
⁸ Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, 2900 boul. Edouard-Montpetit, Montréal, Québec H3T 1J4, Canada; Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 Saint-Denis Street, Montréal, Québec H2X 0A9, Canada. Electronic address: didier.jutras-aswad@umontreal.ca.

PMID: 37003540
DOI: 10.1016/j.josat.2023.209031

Abstract

Introduction: Conflictual evidence exists regarding the effects of cannabis use on the outcomes of opioid agonist therapy (OAT). In this exploratory analysis, we examined the effect of recent cannabis use on opioid use, craving, and withdrawal symptoms, in individuals participating in a trial comparing flexible buprenorphine/naloxone (BUP/NX) take-home dosing model to witnessed ingestion of methadone.

Methods: We analyzed data from a multi-centric, pragmatic, 24-week, open label, randomized controlled trial in individuals with prescription-type opioid use disorder (n = 272), randomly assigned to BUP/NX (n = 138) or methadone (n = 134). The study measured last week cannabis and opioid use via timeline-follow back, recorded at baseline and every two weeks during the study. Craving symptoms were measured using the Brief Substance Craving Scale at baseline, and weeks 2, 6, 10, 14, 18 and 22. The study measured opioid withdrawal symptoms via Clinical Opiate Withdrawal Scale at treatment initiation and weeks 2, 4, and 6.

Results: The mean maximum dose taken during the study was 17.3 mg/day (range = 0.5-32 mg/day) for BUP/NX group and 67.7 mg/day (range = 10-170 mg/day) in the methadone group. Repeated measures generalized linear mixed models demonstrated that cannabis use in the last week (mean of 2.3 days) was not significantly associated with last week opioid use (aβ ± standard error (SE) = -0.06 ± 0.04; p = 0.15), craving (aβ ± SE = -0.05 ± 0.08, p = 0.49), or withdrawal symptoms (aβ ± SE = 0.09 ± 0.1, p = 0.36). Bayes factor (BF) for each of the tested models supported the null hypothesis (BF < 0.3).

Conclusions: The current study did not demonstrate a statistically significant effect of cannabis use on outcomes of interest in the context of a pragmatic randomized-controlled trial. These findings replicated previous results reporting no effect of cannabis use on opioid-related outcomes.

Trial registration: ClinicalTrials.gov NCT03033732.

Keywords: Cannabinoid; Cannabis; Craving; Opioid use disorder; Withdrawal.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships, none of these organizations were involved in this study. Laurent Elkrief reports a relationship with Strem Biotechnologies Inc. that includes: equity or stocks. Laurent Elkrief reports a relationship with OneCare Inc. that includes: equity or stocks. M. Eugenia Socias reports a relationship with Indivior that includes: funding grants. Bernard Le Foll reports a relationship with Pfizer Global Research and Development that includes: funding grants. Bernard Le Foll reports a relationship with Brainsway that includes: funding grants. Bernard Le Foll reports a relationship with Bioprojet that includes: funding grants. Bernard Le Foll reports a relationship with Alkermes Inc. that includes: funding grants. Bernard Le Foll reports a relationship with Canopy Growth Corporation that includes: funding grants. Bernard Le Foll reports a relationship with American Chemical Society that includes: funding grants. Bernard Le Foll reports a relationship with Aurora that includes: non-financial support. Bernard Le Foll reports a relationship with Indivior that includes: consulting or advisory and funding grants. Stephanie Marsan reports a relationship with Indivior that includes: consulting or advisory. Didier Jutras-Aswad reports a relationship with Cardiol Therapeutics that includes: non-financial support.

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Differential effect of cannabis use on opioid agonist treatment outcomes: Exploratory analyses from the OPTIMA study

Collaborators

Affiliations

Differential effect of cannabis use on opioid agonist treatment outcomes: Exploratory analyses from the OPTIMA study

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Collaborators

Affiliations

Abstract

Conflict of interest statement

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