Behavioral Therapy as an Adjunct to Buprenorphine Treatment for Opioid Use Disorder: A Secondary Analysis of 4 Randomized Clinical Trials.

Importance: Several large, randomized clinical trials have tested the efficacy of adding behavioral therapy to medical management (high-quality, low-intensity medical counseling) and buprenorphine treatment of opioid use disorder. These studies have consistently reported strong rates of treatment response overall, without a significant additive benefit of additional behavioral therapy.

Objective: To address gaps in knowledge about additional behavioral therapy for patients receiving buprenorphine, including the association of additional behavioral therapy with retention and functional outcomes, and whether certain subgroups respond better to additional behavioral therapy.

Pilot testing a novel remotely delivered intensive outpatient program for hospitalized patients with opioid use disorder.

Background: Individuals with opioid use disorder (OUD) are frequently hospitalized for injection-related medical complications, yet they often receive inadequate treatment for the OUD itself. We previously conducted a qualitative study to adapt an existing remotely delivered intensive outpatient program (IOP) specifically for hospitalized patients with OUD. We then conducted a pilot feasibility and acceptability study to assess the program.

Primary Care Patients With Opioid Use Disorder Symptoms: Initiation and Engagement in Treatment With Medicine.

Purpose: There is a critical need to treat opioid use disorder (OUD) in primary care. We describe the incidence of OUD medication treatment among primary care patients who reported opioid use and moderate or severe symptoms of substance use disorder (SUD), as defined by the (), during routine care.

Method: This retrospective cohort study used electronic health record and insurance claims data from 33 primary care clinics in Washington that routinely screen for substance use and ask patients who report daily cannabis use or any past-year drug use to complete a Substance Use Symptom Checklist (Checklist).

Modulating mechanisms of adverse childhood experiences in a mindfulness-based intervention: preliminary insights from an opioid use disorder study.

Introduction: Adverse childhood experiences (ACE) are transdiagnostic developmental risk factors for various mental and physical health issues, including Opioid Use Disorder (OUD). Existing research demonstrated ACE not only affects the onset, severity, and comorbidity of disorders, but also affects treatment responses. To investigate whether and how ACE modulates treatment effects of Mindfulness Based Intervention (MBI), we conducted secondary analysis on the longitudinal data from a recent clinical trial on the effects of a MBI during outpatient buprenorphine treatment.

Brief Report: Effectiveness of two financial incentives on patient follow-up after brief substance use disorder inpatient treatment.

Background And Objectives: Clinical follow-up data after substance use disorder (SUD) treatment provides important information about treatment effectiveness, yet compliance is a challenge. We compared financial incentives for obtaining follow-up data from adults receiving inpatient SUD treatment.

Methods: Participants (N = 237) were randomized to receive a guaranteed incentive, raffle-based incentive, or no incentive for completing a 1-month follow-up assessment.

The 24-year course of substance use disorders in patients with borderline personality disorder and personality-disordered comparison subjects.

Background And Objectives: The purpose of this study is to detail the long-term course of substance use disorders (SUDs) among patients with borderline personality disorder (BPD) and subjects with other personality disorders (OPD).

Methods: Two hundred and ninety patients with BPD and 72 subjects with OPD were assessed at baseline and 12 contiguous waves of follow-up as part of the McLean Study of Adult Development (MSAD). The SCID-I for DSM-III-R Axis I disorders was administered 13 times (at baseline admission and at 12 follow-up periods).

Menstrual Pain and Substance Use in Women Receiving Inpatient Treatment for Substance Use Disorders.

Objectives: Pain is a risk factor for substance use and can negatively affect outcomes of substance use disorder (SUD) treatment. Menstrual pain is common among menstruating women yet has received little attention in the substance use literature. This study aimed to characterize menstrual pain and explore the association between menstrual pain and substance use in women receiving SUD treatment.

Optimizing retention strategies for opioid use disorder pharmacotherapy: The retention phase of the CTN-0100 trial (RDD).

Introduction And Background: The three medications approved to address OUD are effective in decreasing opioid use and morbidity and mortality; however, their utility is limited by high rates of dropout from treatment. The CTN-0100 trial will develop an evidence base for strategies to improve retention on buprenorphine and extended-release naltrexone.

Research Design And Methods: The National Drug Abuse Treatment Clinical Trials Network (CTN) study CTN-0100, "Optimizing Retention, Duration and Discontinuation Strategies for Opioid Use Disorder Pharmacotherapy" (RDD), is a multicenter, randomized, non-blinded trial enrolling more than a thousand patients from 18 community-based substance use disorder treatment programs.

Mindfulness Training vs Recovery Support for Opioid Use, Craving, and Anxiety During Buprenorphine Treatment: A Randomized Clinical Trial.

Importance: During buprenorphine treatment for opioid use disorder (OUD), risk factors for opioid relapse or treatment dropout include comorbid substance use disorder, anxiety, or residual opioid craving. There is a need for a well-powered trial to evaluate virtually delivered groups, including both mindfulness and evidence-based approaches, to address these comorbidities during buprenorphine treatment.

Objective: To compare the effects of the Mindful Recovery Opioid Use Disorder Care Continuum (M-ROCC) vs active control among adults receiving buprenorphine for OUD.

Capturing the Full Range of Buprenorphine Treatment Response.

Importance: Reliance on abstinence-based treatment success rules may fail to capture the full continuum of treatment response to buprenorphine plus medical counseling (BUP+MC) for opioid use disorder (OUD).

Objective: To describe patterns of reduction in illicit opioid use of patients both labeled as a success and nonsuccess based on an abstinent-based treatment outcome rule.

Design, Setting, And Participants: This study is a secondary data analysis of 4 harmonized randomized clinical trials on BUP+MC for OUD from multiple sites that included 869 patients with OUD.

Racial and ethnic differences in self-reported barriers to substance use treatment among emergency department patients.

Background And Objectives: As overdose rates rise among non-White Americans, understanding barriers to substance use disorder (SUD) treatment access by race and ethnicity is important. This study explores self-reported barriers to SUD treatment by race and ethnicity in emergency department (ED) populations.

Methods: We conducted a secondary, exploratory analysis of a randomized trial of patients not seeking SUD treatment who endorsed active drug use at six academic EDs.

Toward AI-driven neuroepigenetic imaging biomarker for alcohol use disorder: A proof-of-concept study.

Alcohol use disorder (AUD) is a disorder of clinical and public health significance requiring novel and improved therapeutic solutions. Both environmental and genetic factors play a significant role in its pathophysiology. However, the underlying epigenetic molecular mechanisms that link the gene-environment interaction in AUD remain largely unknown.

Developing a remotely delivered intensive outpatient program adapted for hospitalized patients with opioid use disorder: A qualitative study.

Introduction: Individuals with opioid use disorder (OUD) who inject drugs have an elevated risk of experiencing serious injection-related infections. While such infections can be treated, treatment for the underlying OUD is often limited. One potential strategy for more intensive addiction treatment is to offer a remotely delivered intensive outpatient program (IOP), adapted from an existing remote IOP ("Smart IOP").

Discontinuation of medication treatment for opioid use disorder after a successful course: The discontinuation phase of the CTN-0100 (RDD) trial.

Introduction And Background: Buprenorphine, and extended-release naltrexone, are effective in decreasing opioid use, morbidity and mortality. The available evidence suggests that these medications should be used for long term treatment; however, patients often ask how long they need to be on medication, and whether it would be safe to discontinue. There are sparse data to guide us.

Effect of the Communities that HEAL intervention on receipt of behavioral therapies for opioid use disorder: A cluster randomized wait-list controlled trial.

Background: The U.S. opioid overdose crisis persists.

Protocol for harmonization of randomized trials testing the addition of behavioral therapy to buprenorphine for opioid use disorder.

Background: Although buprenorphine is an effective treatment for opioid use disorder (OUD), much remains to be understood about treatment non-response and methods for improving treatment retention. The addition of behavioral therapies to buprenorphine has not yielded consistent benefits for opioid outcomes, on average. However, several studies suggest that certain subgroups may benefit from the combination of buprenorphine and behavioral therapy, highlighting the potential for personalized approaches to treatment.

Cognitive behavioral therapy for anxiety and opioid use disorder: Development and pilot testing.

Introduction: Anxiety disorders are highly prevalent among people with opioid use disorder (OUD), and they have a negative impact on disorder course and treatment outcomes. The objective of this Stage 1 A/1B behavioral treatment development trial was to develop a novel cognitive-behavioral therapy (CBT) protocol for co-occurring anxiety disorders and OUD.

Methods: Following a period of iterative manual development involving patient interviews and feedback from content experts, we tested a 12-session individual CBT protocol in a small, open pilot trial (N = 5).

Effects of live-online, group mindfulness training on opioid use and anxiety during buprenorphine treatment: A comparative effectiveness RCT.

Background: Office-based opioid treatment with buprenorphine has emerged as a popular evidence-based treatment for opioid use disorder. Unfortunately, psychosocial stress, anxiety, pain, and co-morbid substance use increase patients' risk for relapse. We designed this study to compare the effects of complementing buprenorphine treatment with 24 weeks of a live-online Mindful Recovery Opioid Care Continuum (M-ROCC) group to a time and attention-matched, live-online Recovery Support Group (RSG) active control condition.

Individual-Level Risk Prediction of Return to Use During Opioid Use Disorder Treatment.

Importance: No existing model allows clinicians to predict whether patients might return to opioid use in the early stages of treatment for opioid use disorder.

Objective: To develop an individual-level prediction tool for risk of return to use in opioid use disorder.

Design, Setting, And Participants: This decision analytical model used predictive modeling with individual-level data harmonized in June 1, 2019, to October 1, 2022, from 3 multicenter, pragmatic, randomized clinical trials of at least 12 weeks' duration within the National Institute on Drug Abuse Clinical Trials Network (CTN) performed between 2006 and 2016.

A Peer Recovery Coach Intervention for Hospitalized Patients with Opioid Use Disorder: A Pilot Randomized Controlled Trial.

Objectives: Patients with opioid use disorder (OUD) are increasingly being hospitalized for acute medical illnesses. Despite initiation of medications for OUD (MOUDs), many discontinue treatment after discharge. To evaluate whether a psychosocial intervention can improve MOUD retention after hospitalization, we conducted a pilot randomized controlled trial of a peer recovery coach intervention.

Multiple imputation for non-monotone missing not at random data using the no self-censoring model.

Although approaches for handling missing data from longitudinal studies are well-developed when the patterns of missingness are monotone, fewer methods are available for non-monotone missingness. Moreover, the conventional missing at random assumption-a natural benchmark for monotone missingness-does not model realistic beliefs about the non-monotone missingness processes (Robins and Gill, 1997). This has provided the impetus for alternative non-monotone missing not at random mechanisms.

Risks of returning to opioid use at treatment entry and early in opioid use disorder treatment: Role of non-opioid substances.

Objective: Patients in treatment with medications for opioid use disorder (MOUD) often report use of other substances in addition to opioids. Few studies exist that examine the relationship between use at treatment entry and early non-opioid use in opioid treatment outcome.

Methodology: We combined and harmonized three randomized, controlled MOUD clinical trials from the National Institutes of Drug Abuse (NIDA) Clinical Trials Network (CTN) (N=2197) and investigated the association of non-opioid substance use at treatment entry and during early treatment with a return to opioid use.