PMID- 36037586
OWN - NLM
STAT- MEDLINE
DCOM- 20220926
LR  - 20221213
IS  - 1879-0046 (Electronic)
IS  - 0376-8716 (Linking)
VI  - 239
DP  - 2022 Oct 1
TI  - Buprenorphine/naloxone and methadone effectiveness for reducing craving in 
      individuals with prescription opioid use disorder: Exploratory results from an 
      open-label, pragmatic randomized controlled trial.
PG  - 109604
LID - S0376-8716(22)00341-6 [pii]
LID - 10.1016/j.drugalcdep.2022.109604 [doi]
AB  - BACKGROUND: Craving reduction is an important target in the treatment of 
      prescription-type opioid use disorder (POUD). In this exploratory analysis, we 
      compared the effectiveness of BUP/NX flexible model of care relative to methadone 
      for craving reduction in individuals with POUD. METHODS: We analyzed data from a 
      multicentric, pragmatic, 24-week open-label randomized controlled trial conducted 
      in participants with POUD (N = 272) who were randomly assigned to BUP/NX model of 
      care with flexible take-home dosing (n = 138) or the standard model of care with 
      closely supervised methadone (n = 134). Treatments were prescribed and 
      administered according to local guidelines, in diverse clinical settings. Craving 
      was measured using the Brief Substance Craving Scale at baseline, week 2, 6, 10, 
      14, 18 and 22. RESULTS: Cravings decreased in both treatment groups over 22 weeks 
      (BUP/NX adjusted mean difference = -5.52, 95% CI = -6.91 to -4.13; methadone 
      adjusted mean difference = -3.95, 95% CI = -5.28 to -2.63; p < 0.001), and were 
      overall lower in the BUP/NX group (adjusted mean = 4.04, 95% CI = 3.43-4.64) than 
      the methadone group (adjusted mean = 5.13, 95% CI = 4.51-5.74; p < 0.001). The 
      time by treatment group interaction (favoring BUP/NX) was statistically 
      significant at week 2 (adjusted mean difference = -1.58, 95% CI = -3.13 to -0.03; 
      p = 0.041). CONCLUSIONS: Compared to the standard methadone model of care, 
      flexible take-home dosing of BUP/NX was associated with lower craving in 
      individuals with POUD. These findings can contribute to guiding shared 
      decision-making regarding OAT treatment in this population.
CI  - Copyright (c) 2022 The Authors. Published by Elsevier B.V. All rights reserved.
FAU - McAnulty, Christina
AU  - McAnulty C
AD  - Department of Psychiatry and Addictology, Faculty of Medicine, Universite de 
      Montreal, 2900 boul, Edouard-Montpetit, Montreal, Quebec H3T 1J4, Canada; 
      Research Centre, Centre Hospitalier de l'Universite de Montreal (CRCHUM), 900 
      Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada.
FAU - Bastien, Gabriel
AU  - Bastien G
AD  - Department of Psychiatry and Addictology, Faculty of Medicine, Universite de 
      Montreal, 2900 boul, Edouard-Montpetit, Montreal, Quebec H3T 1J4, Canada; 
      Research Centre, Centre Hospitalier de l'Universite de Montreal (CRCHUM), 900 
      Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada.
FAU - Eugenia Socias, M
AU  - Eugenia Socias M
AD  - British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, 
      British Columbia V6Z 2A9, Canada; Department of Medicine, Faculty of Medicine, 
      University of British Columbia, 1045 Howe Street, Vancouver, British Columbia V6Z 
      2A9, Canada.
FAU - Bruneau, Julie
AU  - Bruneau J
AD  - Research Centre, Centre Hospitalier de l'Universite de Montreal (CRCHUM), 900 
      Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada; Department of Family and 
      Emergency Medicine, Faculty of Medicine, Universite de Montreal, 2900 boul, 
      Edouard-Montpetit, Montreal, Quebec H3T 1J4, Canada.
FAU - Foll, Bernard Le
AU  - Foll BL
AD  - Department of Pharmacology and Toxicology, Faculty of Medicine, Medical Sciences 
      Building, University of Toronto, 1 King's College Circle, Toronto, Ontario M5S 
      1A8, Canada; Department of Family and Community Medicine, Faculty of Medicine, 
      University of Toronto, 500 University Avenue, 5th floor, Toronto, Ontario M5G 
      1V7, Canada; Department of Psychiatry, University of Toronto, 250 College Street, 
      8th floor, Toronto, Ontario M5T 1R8, Canada; Dalla Lana School of Public Health, 
      University of Toronto, 155 College Street, Toronto, Ontario M5T 3M7, Canada; 
      Translational Addiction Research Laboratory, Campbell Family Mental Health 
      Research Institute, Center for Addiction and Mental Health (CAMH), 33 Ursula 
      Franklin Street, Toronto, Ontario M5S 2S1, Canada.
FAU - Lim, Ron
AU  - Lim R
AD  - Department of Medicine and Psychiatry, Cumming School of Medicine, University of 
      Calgary, 2500 University Drive NW, Calgary, Alberta T2N 1N4, Canada.
FAU - Brissette, Suzanne
AU  - Brissette S
AD  - Research Centre, Centre Hospitalier de l'Universite de Montreal (CRCHUM), 900 
      Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada; Department of Family and 
      Emergency Medicine, Faculty of Medicine, Universite de Montreal, 2900 boul, 
      Edouard-Montpetit, Montreal, Quebec H3T 1J4, Canada.
FAU - Ledjiar, Omar
AU  - Ledjiar O
AD  - Unite de recherche Clinique appliquee (URCA), Research Centre, Centre Hospitalier 
      Ste-Justine, 3175 chemin de la Cote Ste-Catherine, Montreal, Quebec H3T 1C5, 
      Canada.
FAU - Marsan, Stephanie
AU  - Marsan S
AD  - Research Centre, Centre Hospitalier de l'Universite de Montreal (CRCHUM), 900 
      Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada; Department of Family and 
      Emergency Medicine, Faculty of Medicine, Universite de Montreal, 2900 boul, 
      Edouard-Montpetit, Montreal, Quebec H3T 1J4, Canada.
FAU - Talbot, Annie
AU  - Talbot A
AD  - Research Centre, Centre Hospitalier de l'Universite de Montreal (CRCHUM), 900 
      Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada; Department of Family and 
      Emergency Medicine, Faculty of Medicine, Universite de Montreal, 2900 boul, 
      Edouard-Montpetit, Montreal, Quebec H3T 1J4, Canada.
FAU - Jutras-Aswad, Didier
AU  - Jutras-Aswad D
AD  - Department of Psychiatry and Addictology, Faculty of Medicine, Universite de 
      Montreal, 2900 boul, Edouard-Montpetit, Montreal, Quebec H3T 1J4, Canada; 
      Research Centre, Centre Hospitalier de l'Universite de Montreal (CRCHUM), 900 
      Saint-Denis Street, Montreal, Quebec H2X 0A9, Canada. Electronic address: 
      didier.jutras-aswad@umontreal.ca.
CN  - OPTIMA Research Group within the Canadian Research Initiative in Substance Misuse
LA  - eng
SI  - ClinicalTrials.gov/NCT03033732
GR  - SMN-139148/CIHR/Canada
GR  - SMN-139149/CIHR/Canada
GR  - SMN-139150/CIHR/Canada
GR  - SMN-139151/CIHR/Canada
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20220817
PL  - Ireland
TA  - Drug Alcohol Depend
JT  - Drug and alcohol dependence
JID - 7513587
RN  - 0 (Buprenorphine, Naloxone Drug Combination)
RN  - 0 (Narcotic Antagonists)
RN  - 36B82AMQ7N (Naloxone)
RN  - 40D3SCR4GZ (Buprenorphine)
RN  - UC6VBE7V1Z (Methadone)
SB  - IM
MH  - *Buprenorphine/therapeutic use
MH  - Buprenorphine, Naloxone Drug Combination/therapeutic use
MH  - Craving
MH  - Humans
MH  - Methadone/therapeutic use
MH  - Naloxone/therapeutic use
MH  - Narcotic Antagonists/therapeutic use
MH  - Opiate Substitution Treatment/methods
MH  - *Opioid-Related Disorders/drug therapy/rehabilitation
MH  - Prescriptions
OTO - NOTNLM
OT  - Buprenorphine/naloxone
OT  - Craving
OT  - Methadone
OT  - Opioid
OT  - Opioid-related disorders
COIS- Conflict of interest DJA is supported by a research scholar award from the Fonds 
      de Recherche du Quebec en Sante. MES is supported by a Michael Smith Foundation 
      for Health Research and St. Paul's Foundation Scholar Award. CM received 
      financial support from l'Institut universitaire sur les dependances for the 
      writing and publication of the article. GB received funding for an accelerated 
      passage from master's to doctorate scholarship from the Universite de Montreal. 
      JB is partly financed by a Tier 1 Canada Research chair in Addiction Medicine and 
      receives or has received support from Gilead Sciences and AbbVie, outside of this 
      study. BLF is supported by a clinician scientist award from the Department of 
      Family and Community Medicine and by the Addiction Psychiatry Chair of the 
      Department of Psychiatry, University of Toronto. BLF also receives or has 
      received support from Pfizer Global Research Awards in Nicotine Dependence 
      (GRAND) Program, Brainsway, Bioprojet, Alkermes, Canopy, ACS, and non-financial 
      support from Aurora for work outside this study. MES is supported by a Michael 
      Smith Foundation for Health Research and St. Paul's Foundation Scholar Award. BLF 
      has a relationship with Indivior that includes consulting and funding grants. SM 
      has a relationship with Indivior that includes consulting. MES has received 
      funding grants from Indivior. AT has a family member who works for ViiV USA. The 
      authors declare no other conflict of interest.
EDAT- 2022/08/30 06:00
MHDA- 2022/09/28 06:00
CRDT- 2022/08/29 18:16
PHST- 2022/02/22 00:00 [received]
PHST- 2022/08/09 00:00 [revised]
PHST- 2022/08/11 00:00 [accepted]
PHST- 2022/08/30 06:00 [pubmed]
PHST- 2022/09/28 06:00 [medline]
PHST- 2022/08/29 18:16 [entrez]
AID - S0376-8716(22)00341-6 [pii]
AID - 10.1016/j.drugalcdep.2022.109604 [doi]
PST - ppublish
SO  - Drug Alcohol Depend. 2022 Oct 1;239:109604. doi: 
      10.1016/j.drugalcdep.2022.109604. Epub 2022 Aug 17.