@article{043ad0d476304b4089924777ea297d3d,
title = "The impact of comorbid psychiatric disorders on methadone maintenance treatment in opioid use disorder: A prospective cohort study",
abstract = "Objective: There is a significant interindividual variability in treatment outcomes in methadone maintenance treatment (MMT) for opioid use disorder (OUD). This prospective cohort study examines the impact of comorbid psychiatric disorders on continued illicit opioid use in patients receiving MMT for OUD. Methods: Data were collected from 935 patients receiving MMT in outpatient clinics between June 2011 and June 2015. Using linear regression analysis, we evaluated the impact of having a comorbid psychiatric disorder on continued illicit opioid use during MMT, adjusting for important confounders. The main outcome measure was percentage of opioid-positive urine screens for 6 months. We conducted a subgroup analysis to determine the influence of specific comorbid psychiatric disorders, including substance use disorders, on continued illicit opioid use. Results: Approximately 80% of participants had at least one comorbid psychiatric disorder in addition to OUD, and 42% of participants had a comorbid substance use disorder. There was no significant association between having a psychiatric comorbidity and continuing opioid use (P=0.248). Results from subgroup analysis, however, suggest that comorbid tranquilizer (β=20.781, P,0.001) and cocaine (β=6.344, P=0.031) use disorders are associated with increased rates of continuing opioid use. Conclusion: Results from our study may serve to guide future MMT guidelines. Specifically, we find that cocaine or tranquilizer use disorder, comorbid with OUD, places patients at high risk for poor MMT outcomes. Treatment centers may choose to gear more intensive therapy toward such populations.",
keywords = "Comorbidity, Methadone, Opioid use disorder, Psychiatric disorder, Substance abuse",
author = "Tea Rosic and Leen Naji and Monica Bawor and Dennis, {Brittany B.} and Carolyn Plater and Marsh, {David C.} and Lehana Thabane and Zainab Samaan",
note = "Funding Information: The authors would like to acknowledge the contributions of Sheelagh Rutherford for her valuable assistance in data collection, the CATC staff and management team for their ongoing collaboration and facilitation of this study, The GENOA team members and volunteers for their countless hours and efforts that made this project possible. The authors would also like to acknowledge the significant contribution of the following study team members: Meha Bhatt, Laura Zielinski, Natalia Mouravska, and Guillaume Pare for their role in study design, acquisition of data, critically revising the manuscript, and approval of the manuscript final version; Jacqueline Hudson for data acquisition, entry, and quality management; Andrew Worster for critical revising the manuscript and approval of the final draft; Michael Varenbut for study design, data acquisition, approval of final draft, and accountability for all aspects of the study; Jeff Daiter for data acquisition and contribution to the study concept. The authors are most grateful to the study participants who volunteered their time, data, and efforts to complete this study that would not have been possible without their generosity. Tea Rosic is funded by the Mach-Gaensslen Foundation summer studentship. This work was supported by research grants from the Canadian Institute for Health Research (CIHR), Ottawa, ON, Canada, The Hamilton Academic Health Sciences Organization, Hamilton, ON, Canada, The Chanchlani Research Centre at the Population Genomics Program, Hamilton, ON, Canada, and Peter Boris Centre for Addictions Research, Hamilton, ON, Canada. The funding bodies have no role in the design of the study, the analysis of data, or publication of results. Publisher Copyright: {\textcopyright} 2017 Rosic et al. This work is published and licensed by Dove Medical Press Limited.",
year = "2017",
month = may,
day = "24",
doi = "10.2147/NDT.S129480",
language = "English (US)",
volume = "13",
pages = "1399--1408",
journal = "Neuropsychiatric Disease and Treatment",
issn = "1176-6328",
publisher = "Dove Medical Press Ltd.",
}
