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

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. 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. 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). 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.

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Déclaration de conflit d'intérêts

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.