当前位置： SCI文献检索 > ADDICTION BIOLOGY期刊下所有文献 > Preliminary evidence of different and clinically meaningful opioid withdrawal phenotypes.

Preliminary evidence of different and clinically meaningful opioid withdrawal phenotypes.

Abstract：

:Opioid use disorder (OUD) is a public health crisis. Differences in opioid withdrawal severity that predict treatment outcome could facilitate the process of matching patients to treatments. This is a secondary analysis of a randomized controlled trial (RCT) that enrolled treatment seeking heroin-users (N = 89, males = 78) into a residential study. Participants maintained on morphine (30 mg, subcutaneous, four-times daily) underwent a naloxone (0.4 mg, IM = intramuscular) challenge session to precipitate withdrawal. Area-under-the-curve (AUC) values from self-reported withdrawal ratings during the challenge session were analyzed using K-means clustering, revealing two phenotype groups. Withdrawal and retention from the subsequent 14-day double-blind, double-dummy RCT comparing three study medications (clonidine, tramadol-ER, and buprenorphine) were evaluated as a function of phenotype. Cluster analyses suggested HIGH (N = 37; mean [SD] subjective opiate withdrawal scale [SOWS]-AUC 123.7 [65.8]) and LOW (N = 52; SOWS-AUC 68.0 [47.7]) withdrawal phenotype groups. HIGH participants were significantly more female and had lower body mass indices than LOW participants; no drug-use variables were significant. Regarding RCT outcomes, HIGH phenotype participants were less likely to be retained in the study (P = 0.02) and had higher mean self-reported withdrawal (P = 0.05) than LOW phenotype participants. A significant interaction in RCT retention was observed between phenotype (P = 0.02) and study medication (P < 0.01). Self-reported withdrawal was significant for phenotype (P = 0.02); study medication trended towards significance (P = 0.07). Results suggest patients have meaningfully different experiences of opioid withdrawal that may predict differential response to opioid pharmacotherapies during supervised withdrawal. Additional prospective research to replicate and more thoroughly evaluate withdrawal phenotype correlates and sex differences is warranted.

journal_name

Addict Biol

journal_title

Addiction biology

authors

Dunn KE,Weerts EM,Huhn AS,Schroeder JR,Tompkins DA,Bigelow GE,Strain EC

doi

10.1111/adb.12680

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

e12680

issue

eissn

1355-6215

issn

1369-1600

journal_volume

pub_type

杂志文章

在线工具

Preliminary evidence of different and clinically meaningful opioid withdrawal phenotypes.