Predictors of abstinence: National Institute of Drug Abuse multisite buprenorphine/naloxone treatment trial in opioid-dependent youth

Geetha A. Subramaniam, Diane Warden, Abu Minhajuddin, Marc J. Fishman, Maxine L. Stitzer, Bryon Adinoff, Madhukar Trivedi, Roger Weiss, Jennifer Potter, Sabrina A. Poole, George E. Woody

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Objective: To examine predictors of opioid abstinence in buprenorphine/naloxone (Bup/Nal)-assisted psychosocial treatment for opioid-dependent youth. Method: Secondary analyses were performed of data from 152 youth (15-21 years old) randomly assigned to 12 weeks of extended Bup/Nal therapy or up to 2 weeks of Bup/Nal detoxification with weekly individual and group drug counseling. Logistic regression models were constructed to identify baseline and during-treatment predictors of opioid-positive urine (OPU) at week 12. Predictors were selected based on significance or trend toward significance (i.e., p < .1), and backward stepwise selection was used, controlling for treatment group, to produce final independent predictors at p ≤ .05. Results: Youth presenting to treatment with previous 30-day injection drug use and more active medical/psychiatric problems were less likely to have a week-12 OPU. Those with early treatment opioid abstinence (i.e., weeks 1 and 2) and those who received additional nonstudy treatments during the study were less likely to have a week-12 OPU and those not completing 12 weeks of treatment were more likely to have an OPU. Conclusions: Youth with advanced illness (i.e., reporting injection drug use and additional health problems) and those receiving ancillary treatments to augment study treatment were more likely to have lower opioid use. Treatment success in the first 2 weeks and completion of 12 weeks of treatment were associated with lower rates of OPU. These findings suggest that youth with advanced illness respond well to Bup/Nal treatment and identify options for tailoring treatment for opioid-dependent youth presenting at community-based settings. Clinical trial registration information-- Buprenorphine/Naloxone-Facilitated Rehabilitation for Opioid Dependent Adolescents; http://www.clinicaltrials.gov; NCT00078130.

Original languageEnglish (US)
Pages (from-to)1120-1128
Number of pages9
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume50
Issue number11
DOIs
StatePublished - Nov 2011

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Opioid Analgesics
Substance-Related Disorders
Therapeutics
Urine
Naloxone Drug Combination Buprenorphine
Logistic Models
Pharmaceutical Preparations
Injections
Psychiatry
Counseling
Rehabilitation
Clinical Trials

Keywords

  • buprenorphine treatment
  • opioid dependent youth
  • treatment predictors

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Developmental and Educational Psychology

Cite this

Predictors of abstinence : National Institute of Drug Abuse multisite buprenorphine/naloxone treatment trial in opioid-dependent youth. / Subramaniam, Geetha A.; Warden, Diane; Minhajuddin, Abu; Fishman, Marc J.; Stitzer, Maxine L.; Adinoff, Bryon; Trivedi, Madhukar; Weiss, Roger; Potter, Jennifer; Poole, Sabrina A.; Woody, George E.

In: Journal of the American Academy of Child and Adolescent Psychiatry, Vol. 50, No. 11, 11.2011, p. 1120-1128.

Research output: Contribution to journalArticle

Subramaniam, Geetha A. ; Warden, Diane ; Minhajuddin, Abu ; Fishman, Marc J. ; Stitzer, Maxine L. ; Adinoff, Bryon ; Trivedi, Madhukar ; Weiss, Roger ; Potter, Jennifer ; Poole, Sabrina A. ; Woody, George E. / Predictors of abstinence : National Institute of Drug Abuse multisite buprenorphine/naloxone treatment trial in opioid-dependent youth. In: Journal of the American Academy of Child and Adolescent Psychiatry. 2011 ; Vol. 50, No. 11. pp. 1120-1128.
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abstract = "Objective: To examine predictors of opioid abstinence in buprenorphine/naloxone (Bup/Nal)-assisted psychosocial treatment for opioid-dependent youth. Method: Secondary analyses were performed of data from 152 youth (15-21 years old) randomly assigned to 12 weeks of extended Bup/Nal therapy or up to 2 weeks of Bup/Nal detoxification with weekly individual and group drug counseling. Logistic regression models were constructed to identify baseline and during-treatment predictors of opioid-positive urine (OPU) at week 12. Predictors were selected based on significance or trend toward significance (i.e., p < .1), and backward stepwise selection was used, controlling for treatment group, to produce final independent predictors at p ≤ .05. Results: Youth presenting to treatment with previous 30-day injection drug use and more active medical/psychiatric problems were less likely to have a week-12 OPU. Those with early treatment opioid abstinence (i.e., weeks 1 and 2) and those who received additional nonstudy treatments during the study were less likely to have a week-12 OPU and those not completing 12 weeks of treatment were more likely to have an OPU. Conclusions: Youth with advanced illness (i.e., reporting injection drug use and additional health problems) and those receiving ancillary treatments to augment study treatment were more likely to have lower opioid use. Treatment success in the first 2 weeks and completion of 12 weeks of treatment were associated with lower rates of OPU. These findings suggest that youth with advanced illness respond well to Bup/Nal treatment and identify options for tailoring treatment for opioid-dependent youth presenting at community-based settings. Clinical trial registration information-- Buprenorphine/Naloxone-Facilitated Rehabilitation for Opioid Dependent Adolescents; http://www.clinicaltrials.gov; NCT00078130.",
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