Treatment Outcomes in Patients With Opioid Use Disorder Who Were First Introduced to Opioids by Prescription: A Systematic Review and Meta-Analysis.
meta-analysis
opioid use disorder
opioids
prescription
systematic review
Journal
Frontiers in psychiatry
ISSN: 1664-0640
Titre abrégé: Front Psychiatry
Pays: Switzerland
ID NLM: 101545006
Informations de publication
Date de publication:
2020
2020
Historique:
received:
01
06
2020
accepted:
28
07
2020
entrez:
2
10
2020
pubmed:
3
10
2020
medline:
3
10
2020
Statut:
epublish
Résumé
Prescription opioid misuse has led to a new cohort of opioid use disorder (OUD) patients who were introduced to opioids through a legitimate prescription. This change has caused a shift in the demographic profile of OUD patients from predominantly young men to middle age and older people. The management of OUD includes medication-assisted treatment (MAT), which produces varying rates of treatment response. In this study, we will examine whether the source of first opioid use has an effect on treatment outcomes in OUD. Using a systematic review of the literature, we will investigate the association between source of first opioid introduction and treatment outcomes defined as continuing illicit opioid use and poly-substance use while in MAT. Medline, EMBASE, CINHAL, and PsycInfo were searched from inception to December 31 The initial search results in 27,345 articles that were screened, and five observational studies were included in the qualitative and quantitative analyses. Our results found that those who were introduced to opioids through a legitimate prescription were significantly less likely to have illicit opioid use (0.70, 95% CI 0.50, 0.99) while on MAT. They were also less likely to use cannabis (0.54, 95% CI 0.32, 0.89), alcohol (0.75, 95% CI 0.59, 0.95), cocaine (0.50, 95% CI 0.29, 0.85), and injection drug use (0.25, 95% CI 0.14, 0.43) than those introduced to opioids through recreational means. This study shows that the first exposure to opioids, whether through a prescription or recreationally, influences prognosis and treatment outcomes of opioid use disorder. Although the increased pattern of prescribing opioids may have led to increased OUD in a new cohort of patients, these patients are less likely to continue to use illicit drugs and have a different prognostic and clinical profile that requires a tailored approach to treatment. PROSPERO CRD42017058143.
Identifiants
pubmed: 33005151
doi: 10.3389/fpsyt.2020.00812
pmc: PMC7485127
doi:
Types de publication
Systematic Review
Langues
eng
Pagination
812Informations de copyright
Copyright © 2020 Sanger, Bhatt, Singhal, Panesar, D’Elia, Trottier, Shahid, Hillmer, Baptist-Mohseni, Roczyki, Soni, Brush, Lovell, Sanger, Samaan, de Souza, Thabane and Samaan.
Références
Lancet. 1999 Jun 26;353(9171):2229-32
pubmed: 10393001
Drug Alcohol Rev. 2014 Jan;33(1):19-26
pubmed: 24261474
Drug Alcohol Depend. 1996 Dec 11;43(3):179-89
pubmed: 9023074
J Pain Res. 2015 Jul 09;8:361-73
pubmed: 26185467
J Addict Med. 2010 Jun;4(2):108-13
pubmed: 20543897
Drug Alcohol Depend. 2019 Jan 1;194:166-172
pubmed: 30445274
Drug Alcohol Depend. 2006 Jan 4;81(1):55-61
pubmed: 15993552
J Behav Health Serv Res. 2005 Jan-Mar;32(1):43-60
pubmed: 15632797
CMAJ. 2017 May 8;189(18):E659-E666
pubmed: 28483845
JAMA Netw Open. 2020 Feb 5;3(2):e200234
pubmed: 32108887
Subst Use Misuse. 2004 Jan;39(1):1-23
pubmed: 15002942
Eur Arch Psychiatry Clin Neurosci. 1995;245(2):114-24
pubmed: 7654787
MMWR Morb Mortal Wkly Rep. 2018 Mar 30;67(12):349-358
pubmed: 29596405
Addiction. 2009 May;104(5):775-83
pubmed: 19344438
Drug Alcohol Depend. 2013 Jul 1;131(1-2):112-8
pubmed: 23333292
PLoS Med. 2009 Jul 21;6(7):e1000097
pubmed: 19621072
Lancet. 2012 Jan 7;379(9810):55-70
pubmed: 22225671
Mol Diagn Ther. 2008;12(2):109-24
pubmed: 18422375
Drug Alcohol Depend. 2004 Feb 7;73(2):199-207
pubmed: 14725960
J Psychoactive Drugs. 2003 Apr-Jun;35(2):253-9
pubmed: 12924748
Syst Rev. 2014 May 16;3:45
pubmed: 24887111
JAMA Netw Open. 2019 Feb 1;2(2):e187621
pubmed: 30707224
Drug Alcohol Rev. 2015 Jul;34(4):427-37
pubmed: 25867685
Drug Alcohol Depend. 2006 May 20;82(3):211-7
pubmed: 16219428
Drug Alcohol Rev. 2018 Feb;37(2):262-272
pubmed: 28884866
Am J Drug Alcohol Abuse. 2010 May;36(3):155-60
pubmed: 20465373
JAMA. 2018 May 1;319(17):1819-1821
pubmed: 29715347
Addict Behav. 1987;12(1):1-6
pubmed: 3565107
Transl Psychiatry. 2019 Nov 11;9(1):282
pubmed: 31712552
J Clin Epidemiol. 2011 Apr;64(4):380-2
pubmed: 21185693
J Pain. 2016 Jan;17(1):101-10
pubmed: 26476264
MMWR Morb Mortal Wkly Rep. 2018 Jan 04;67(5152):1419-1427
pubmed: 30605448
J Gerontol B Psychol Sci Soc Sci. 2014 Nov;69(6):870-80
pubmed: 24149517
J Subst Abuse Treat. 2013 Mar;44(3):295-300
pubmed: 23021097
Cochrane Database Syst Rev. 2009 Jul 08;(3):CD002209
pubmed: 19588333
Postgrad Med. 2019 Jan;131(1):52-59
pubmed: 30415596
BMJ. 2006 Sep 16;333(7568):597-600
pubmed: 16974018
Pharmacoepidemiol Drug Saf. 2014 Mar;23(3):314-20
pubmed: 24677496
Ann Intern Med. 2017 Apr 4;166(7):514-530
pubmed: 28192789
J Gen Intern Med. 2007 Apr;22(4):527-30
pubmed: 17372805
Curr Opin Psychiatry. 2017 Jul;30(4):238-246
pubmed: 28426545
Syst Rev. 2018 Jan 25;7(1):16
pubmed: 29368662
Can Fam Physician. 2019 Sep;65(9):612-614
pubmed: 31515308
JAMA Netw Open. 2019 Apr 5;2(4):e192851
pubmed: 31026029
J Subst Abuse Treat. 2010 Dec;39(4):378-83
pubmed: 20727704
J Subst Abuse Treat. 2012 Oct;43(3):285-90
pubmed: 22301084
BMJ. 2011 Oct 18;343:d5928
pubmed: 22008217
N Engl J Med. 2016 Jul 28;375(4):357-68
pubmed: 27464203
Biol Sex Differ. 2017 Mar 30;8:8
pubmed: 28367308
Lancet. 2012 Jan 7;379(9810):17-8
pubmed: 22232799
Pain Physician. 2018 Nov;21(6):E623-E632
pubmed: 30508993
Addiction. 2000 Jan;95(1):77-84
pubmed: 10723832
Law Enforc Exec Forum. 2007 Nov;7(7):127-141
pubmed: 25267926
Am J Psychiatry. 2006 May;163(5):764-5
pubmed: 16648309
Am J Geriatr Psychiatry. 2004 Sep-Oct;12(5):539-41
pubmed: 15353395
Mayo Clin Proc. 2013 Jul;88(7):697-707
pubmed: 23790544
Am J Public Health. 2014 Aug;104(8):e32-42
pubmed: 24922138