Examination of Correlates of OUD Outcomes in Young Adults: Secondary Analysis From the XBOT Trial.
Journal
The American journal on addictions
ISSN: 1521-0391
Titre abrégé: Am J Addict
Pays: England
ID NLM: 9208821
Informations de publication
Date de publication:
09 2021
09 2021
Historique:
revised:
16
04
2021
received:
31
12
2020
accepted:
16
04
2021
pubmed:
3
6
2021
medline:
26
11
2021
entrez:
2
6
2021
Statut:
ppublish
Résumé
Opioid use disorder (OUD) treatment outcomes are poorer for young adults than older adults. Developmental differences are broadly implicated, but particular vulnerability factor interactions are poorly understood. This study sought to identify moderators of OUD relapse between age groups. This secondary analysis compared young adults (18-25) to older adults (26+) from a comparative effectiveness trial ("XBOT") that randomized (N = 570) participants to extended-release naltrexone or sublingual buprenorphine-naloxone. We explored the relationship between 25 prespecified patient baseline characteristics and relapse to regular opioid use by age group and treatment condition, using logistic regression. Young adults (n = 111) had higher rates of 24-week relapse than older adults (n = 459) (70.3% vs 58.8%) and differed on a number of specific characteristics, including more smokers, more intravenous opioid use, and more cannabis use. No significant moderators predicted relapse, in either three-way or two-way interactions. No baseline factors were identified as moderating the relationship between age group and opioid relapse, nor any interactions between baseline characteristics, age group, and treatment condition to predict opioid relapse. Poorer treatment outcomes for young adults are likely associated with multiple developmental vulnerabilities rather than any single predominant factor. Although not reaching significance, several characteristics (using heroin, smoking tobacco, high levels of depression/anxiety, or treatment because of family/friends) showed higher odds ratio point estimates for relapse in young adults than older adults. This is the first study to explore moderators of worse OUD treatment outcomes in young adults, highlighting the need to identify predictor variables that could inform treatment enhancements. (Am J Addict 2021;00:1-12).
Sections du résumé
BACKGROUND AND OBJECTIVES
Opioid use disorder (OUD) treatment outcomes are poorer for young adults than older adults. Developmental differences are broadly implicated, but particular vulnerability factor interactions are poorly understood. This study sought to identify moderators of OUD relapse between age groups.
METHODS
This secondary analysis compared young adults (18-25) to older adults (26+) from a comparative effectiveness trial ("XBOT") that randomized (N = 570) participants to extended-release naltrexone or sublingual buprenorphine-naloxone. We explored the relationship between 25 prespecified patient baseline characteristics and relapse to regular opioid use by age group and treatment condition, using logistic regression.
RESULTS
Young adults (n = 111) had higher rates of 24-week relapse than older adults (n = 459) (70.3% vs 58.8%) and differed on a number of specific characteristics, including more smokers, more intravenous opioid use, and more cannabis use. No significant moderators predicted relapse, in either three-way or two-way interactions.
CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE
No baseline factors were identified as moderating the relationship between age group and opioid relapse, nor any interactions between baseline characteristics, age group, and treatment condition to predict opioid relapse. Poorer treatment outcomes for young adults are likely associated with multiple developmental vulnerabilities rather than any single predominant factor. Although not reaching significance, several characteristics (using heroin, smoking tobacco, high levels of depression/anxiety, or treatment because of family/friends) showed higher odds ratio point estimates for relapse in young adults than older adults. This is the first study to explore moderators of worse OUD treatment outcomes in young adults, highlighting the need to identify predictor variables that could inform treatment enhancements. (Am J Addict 2021;00:1-12).
Identifiants
pubmed: 34075644
doi: 10.1111/ajad.13176
pmc: PMC8429062
mid: NIHMS1701723
doi:
Substances chimiques
Analgesics, Opioid
0
Buprenorphine, Naloxone Drug Combination
0
Delayed-Action Preparations
0
Naltrexone
5S6W795CQM
Banques de données
ClinicalTrials.gov
['NCT02032433']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
433-444Subventions
Organisme : NIDA NIH HHS
ID : UG1 DA015831
Pays : United States
Organisme : NIDA NIH HHS
ID : U10 DA013046
Pays : United States
Organisme : NIDA NIH HHS
ID : UG1 DA013732
Pays : United States
Organisme : NIDA NIH HHS
ID : UG1 DA013714
Pays : United States
Organisme : NIDA NIH HHS
ID : UG1/ U10DA013035
Pays : United States
Organisme : NIDA NIH HHS
ID : UG1 DA013035
Pays : United States
Organisme : NIDA NIH HHS
ID : U10 DA013732
Pays : United States
Organisme : NIDA NIH HHS
ID : UG1/U10DA013034
Pays : United States
Organisme : National Center on Integrative and Complimentary Health
ID : AT010614
Organisme : NIDA NIH HHS
ID : U10DA013046
Pays : United States
Organisme : NIDA NIH HHS
ID : U10 DA015833
Pays : United States
Organisme : NIDA NIH HHS
ID : U10 DA013720
Pays : United States
Organisme : NIDA NIH HHS
ID : U10 DA015831
Pays : United States
Organisme : NIDA NIH HHS
ID : U10 DA013035
Pays : United States
Organisme : NIDA NIH HHS
ID : U10 DA013714
Pays : United States
Organisme : NCCIH NIH HHS
ID : R61 AT010614
Pays : United States
Organisme : NIDA NIH HHS
ID : UG1 DA013720
Pays : United States
Organisme : NIDA NIH HHS
ID : U10 DA013045
Pays : United States
Organisme : NIDA NIH HHS
ID : U10 DA013034
Pays : United States
Informations de copyright
© 2021 American Academy of Addiction Psychiatry.
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