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. 2024;22(6):4004-4020.
doi: 10.1007/s11469-023-01098-8. Epub 2023 Jun 28.

The Impact of Longitudinal Substance Use Patterns on the Risk of Opioid Agonist Therapy Discontinuation: A Repeated Measures Latent Class Analysis

Zishan Cui  1   2 , Mohammad Karamouzian  1   3 , Michael Law  2   4 , Kanna Hayashi  1   5 , M-J Milloy  1   6 , Thomas Kerr  1   6
Affiliations

The Impact of Longitudinal Substance Use Patterns on the Risk of Opioid Agonist Therapy Discontinuation: A Repeated Measures Latent Class Analysis

Zishan Cui et al. Int J Ment Health Addict. 2024.

Abstract

Polysubstance use is prevalent among individuals on opioid agonist treatment (OAT), yet past studies have focused primarily on distinct substances and their association with OAT retention. Data was collected from two prospective cohorts between 2005 and 2020 in Vancouver, Canada. Among 13,596 visits contributed by 1445 participants receiving OAT, we employed repeated measures latent class analysis using seven indicators and identified four longitudinal substance use classes. Using marginal structural Cox modeling, we found that compared to the primarily crack use class, the two opioid and stimulant use classes carried a higher risk of OAT discontinuation, while the primarily cannabis and crack use class had a lower OAT discontinuation risk. Our findings highlight the need for integrated treatment strategies to manage the co-use of opioids and stimulants during receipt of OAT and suggest future research should explore the potential of cannabis as a harm reduction strategy or adjunctive treatment to OAT. Word count: 150/150.

Supplementary information: The online version contains supplementary material available at 10.1007/s11469-023-01098-8.

Keywords: Marginal Structural Modeling; OAT Discontinuation; OAT Retention; Opioid Agonist Therapy (OAT); Polysubstance Use; Repeated Measures Latent Class Analysis (RMLCA).

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Conflict of interest statement

Conflict of interestMJM’s institution has received an unstructured gift from NG Biomed, Ltd., to support his research. MJM is the Canopy Growth professor of cannabis science at the University of British Columbia, a position created by unstructured gifts to the university from Canopy Growth, a licensed producer of cannabis, and the Government of British Columbia’s Ministry of Mental Health and Addictions. Funding sources had no role in study design; collection, analysis, and interpretation of data; writing the report; and the decision to submit the report for publication. All authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Repeated measures latent class model fit statistics
Fig. 2
Fig. 2
Four latent substance use class item response probability loadings on substance use indicators among participants receiving OAT in Vancouver, Canada. Regular: at least weekly. All substance use indicators refer to the last six months prior to the interview date
Fig. 3
Fig. 3
Substance use class distributions by calendar year among participants receiving OAT in Vancouver, Canada
Fig. 4
Fig. 4
OAT discontinuation rate for the entire sample and stratified by substance use class among participants receiving OAT in Vancouver, Canada
See this image and copyright information in PMC

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