Adverse childhood experiences predict opioid relapse during treatment among rural adults
| Autor: | Daniel D. Sumrok, James G. Murphy, Meghan E. McDevitt-Murphy, Karen C. Johnson, Frank Andrasik, Karen J. Derefinko, Zoran Bursac, Francisco I. Salgado García, Kevin M. Talley |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Rural Population medicine.medical_specialty Prescription drug Narcotic Antagonists 030508 substance abuse Medicine (miscellaneous) Toxicology Odds Young Adult 03 medical and health sciences 0302 clinical medicine Adverse Childhood Experiences Recurrence Risk Factors Internal medicine Ambulatory Care Opiate Substitution Treatment medicine Humans 030212 general & internal medicine Aged Aged 80 and over business.industry Medical record Public health Opioid use disorder Middle Aged Opioid-Related Disorders medicine.disease Substance abuse Psychiatry and Mental health Clinical Psychology Opioid Psychotherapy Group Female Observational study Buprenorphine Naloxone Drug Combination 0305 other medical science business medicine.drug |
| Zdroj: | Addictive Behaviors. 96:171-174 |
| ISSN: | 0306-4603 |
| DOI: | 10.1016/j.addbeh.2019.05.008 |
| Popis: | Adverse childhood experiences (ACE) are a public health concern and strong predictor of substance abuse, but no studies to date have explored the association between ACE and opioid relapse during medication-assisted treatment. Using an observational design, we examined this relationship using archived medical records of 87 patients who attended opioid use disorder treatment (buprenorphine-naloxone and group counseling) at a rural medical clinic. All variables were collected from medical files. ACE scores were derived from a 10-item screening questionnaire administered at intake, a regular procedure for this clinic. The primary outcome was opioid relapse observed at each visit, as indicated by self-reported opioid use, positive urine drug screen for opioids, or prescription drug database results for opioid acquisition. The sample was 100% Caucasian and 75% male. A total of 2052 visit observations from the 87 patients were extracted from the medical records. Patients had an average of 23.6 (SD = 22) treatment visits. Opioid relapse occurred in 54% of patients. Results indicated that for every unit increase in ACE score, there was an increase of 17% in the odds of relapse (95% CI: 1.05-1.30, p = .005). Additionally, each treatment visit was associated with a 2% reduction in the odds of opioid relapse (95% CI: 0.97-0.99, p = .008). We conclude that ACE may increase the risk for poor response to buprenorphine-naloxone treatment due to high rates of opioid relapse during the first treatment visits. However, consistent adherence to treatment is likely to reduce the odds of opioid relapse. |
| Databáze: | OpenAIRE |
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