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Interim buprenorphine treatment during delays to comprehensive treatment: Changes in psychiatric symptoms.

ABSTRACT: Prevalence of depression, anxiety, and mood disorders among individuals with opioid use disorder far exceeds that of the general population. While psychiatric symptoms often improve upon entry into opioid treatment, this has typically been seen with treatments involving psychosocial counseling. In this secondary analysis, we examined changes in psychiatric symptoms during a randomized clinical trial evaluating an interim buprenorphine treatment without counseling among individuals awaiting entry into comprehensive treatment. Waitlisted adults with opioid use disorder (N = 50) were randomized to one of two 12-week conditions: interim buprenorphine treatment (IBT; n = 25) consisting of buprenorphine maintenance using a computerized medication dispenser, with bimonthly clinic visits and technology-assisted monitoring, or waitlist control (WLC; n = 25), wherein participants remained on the waitlist of their local clinic. All participants completed assessments of psychiatric symptoms at intake and Study Weeks 4, 8, and 12. We examined changes on the Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), Brief Symptom Inventory (BSI), and Psychiatric subscale of the Addiction Severity Index (ASI). Significant group-by-time interactions were observed for all measures of psychiatric severity examined: BAI (p < .05), BDI-II (p < .01), 5 BSI subscales (ps < .05), and the ASI Psychiatric subscale (p < .05). On all measures, IBT participants reported significantly reduced psychiatric severity at the 4-, 8-, and 12-week assessments relative to baseline. In contrast, there were no significant changes in psychiatric symptoms among WLC participants. IBT without counseling may improve psychiatric distress among waitlisted individuals with opioid use disorder. (PsycINFO Database Record

SUBMITTER: Streck JM

PROVIDER: S-EPMC6072576 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Interim buprenorphine treatment during delays to comprehensive treatment: Changes in psychiatric symptoms.

Streck Joanna M JM Ochalek Taylor A TA Badger Gary J GJ Sigmon Stacey C SC

Experimental and clinical psychopharmacology 20180625 4

Prevalence of depression, anxiety, and mood disorders among individuals with opioid use disorder far exceeds that of the general population. While psychiatric symptoms often improve upon entry into opioid treatment, this has typically been seen with treatments involving psychosocial counseling. In this secondary analysis, we examined changes in psychiatric symptoms during a randomized clinical trial evaluating an interim buprenorphine treatment without counseling among individuals awaiting entry ...[more]

PMID: 29939049

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Project description:ObjectiveThe authors examined the impact of COVID-19-related policies reducing barriers to telehealth delivery of buprenorphine treatment for opioid use disorder (OUD) on buprenorphine treatment across different modalities (telephone, video, and in-person visits).MethodsThis was a national retrospective cohort study with interrupted time-series analyses to examine the impact of policy changes in March 2020 on buprenorphine treatment for OUD in the Veterans Health Administration, during the year before the start of the COVID-19 pandemic (March 2019 to February 2020) and during the first year of the pandemic (March 2020 to February 2021). The authors also examined trends in the use of telephone, video, and in-person visits for buprenorphine treatment and compared patient demographic characteristics and retention in buprenorphine treatment across the two periods.ResultsThe number of patients receiving buprenorphine increased from 13,415 in March 2019 to 15,339 in February 2021. By February 2021, telephone visits were used by the most patients (50.2%; 4,456 visits), followed by video visits (32.4%; 2,870 visits) and in-person visits (17.4%; 1,544 visits). During the pre-pandemic period, the number of patients receiving buprenorphine increased significantly by 103 patients per month. After the COVID-19 policy changes, there was an immediate increase of 265 patients in the first month, and the number continued to increase significantly, at a rate of 47 patients per month. The demographic characteristics of patients receiving buprenorphine during the pandemic period were similar to those during the pre-pandemic period, but the proportion of patients reaching 90-day retention on buprenorphine treatment decreased significantly from 49.6% to 47.7%, while days on buprenorphine increased significantly from 203.8 to 208.7.ConclusionsThe number of patients receiving buprenorphine continued to increase after the COVID-19 policy changes, but the delivery of care shifted to telehealth visits, suggesting that any reversal of COVID-19 policies must be carefully considered.

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Interim buprenorphine treatment during delays to comprehensive treatment: Changes in psychiatric symptoms.

Publications

Interim buprenorphine treatment during delays to comprehensive treatment: Changes in psychiatric symptoms.

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