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Stress, craving and mood as predictors of early dropout from opioid agonist therapy.
- Source :
-
Drug and alcohol dependence [Drug Alcohol Depend] 2019 Sep 01; Vol. 202, pp. 200-208. Date of Electronic Publication: 2019 Jul 16. - Publication Year :
- 2019
-
Abstract
- Background: Treatment with opioid agonists is effective for opioid use disorder, but early discontinuation of treatment is a major obstacle to success. Intensive longitudinal methods - which take many repeated measurements over time, usually in the field- have provided unique insight into the effects of stress, mood and craving on drug use while people are being treated; these methods might also be useful for studying the processes that lead people to drop out of treatment.<br />Methods: Ecological momentary assessment (EMA) was conducted for up to 17 weeks by obtaining multiple electronic diary entries per day from 238 participants being treated with methadone or buprenorphine-naloxone. Survival analysis was used to study two outcomes: dropping out of treatment and noncompliance with EMA self-report requirements. Self-reports of stress, craving, and mood were used as time-varying predictors. Demographic and psychosocial variables measured with the Addiction Severity Index at the start of treatment were used as time-invariant predictors.<br />Results: Dropping out of treatment was more likely in participants with more reported hassles (a measure of stress), higher levels of cocaine craving, lower levels of positive mood, a recent history of emotional abuse, a recent history of being bothered frequently by psychological problems, and with buprenorphine rather than methadone as their medication. In contrast, study noncompliance was not significantly associated with any of the variables analyzed.<br />Conclusions: Assessment of stress, craving and mood during treatment might identify people who are at greater risk of dropping out, and therapeutic interventions targeting these processes might increase retention.<br /> (Published by Elsevier B.V.)
- Subjects :
- Adult
Analgesics, Opioid therapeutic use
Buprenorphine, Naloxone Drug Combination therapeutic use
Ecological Momentary Assessment
Female
Humans
Male
Methadone therapeutic use
Middle Aged
Opioid-Related Disorders drug therapy
Withholding Treatment
Affect drug effects
Craving drug effects
Opiate Substitution Treatment adverse effects
Opioid-Related Disorders psychology
Patient Dropouts psychology
Stress, Psychological chemically induced
Subjects
Details
- Language :
- English
- ISSN :
- 1879-0046
- Volume :
- 202
- Database :
- MEDLINE
- Journal :
- Drug and alcohol dependence
- Publication Type :
- Academic Journal
- Accession number :
- 31357121
- Full Text :
- https://doi.org/10.1016/j.drugalcdep.2019.05.026