A Prospective Study to Investigate Predictors of Relapse among Patients with Opioid Use Disorder Treated with Methadone

Author:

Naji Leen1,Dennis Brittany B.23,Bawor Monica2,Plater Carolyn4,Pare Guillaume3,Worster Andrew45,Varenbut Michael4,Daiter Jeff4,Marsh David C.46,Desai Dipika7,Thabane Lehana389,Samaan Zainab371011

Affiliation:

1. Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.

2. St. George's University of London, London, United Kingdom.

3. Department of Clinical Epidemiology and Biostatistics, McMaster University, ON, Hamilton, Canada.

4. Canadian Addiction Treatment Centre, Richmond Hill, ON, Canada.

5. Department of Medicine, Hamilton General Hospital, Hamilton, ON, Canada.

6. Northern Ontario School of Medicine, Sudbury, ON, Canada.

7. Population Genomics Program, Chanchlani Research Center, McMaster University, Hamilton, ON, Canada.

8. Centre for Evaluation of Medicine, Hamilton, ON, Canada.

9. System Linked Research Unit, Hamilton, ON, Canada.

10. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.

11. Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.

Abstract

Introduction Concomitant opioid abuse is a serious problem among patients receiving methadone maintenance treatment (MMT) for opioid use disorder. This is an exploratory study that aims to identify predictors of the length of time a patient receiving MMT for opioid use disorder remains abstinent (relapse-free). Methods Data were collected from 250 MMT patients enrolled in addiction treatment clinics across Southern Ontario. The impact of certain clinical and socio-demographic factors on the outcome (time until opioid relapse) was determined using a Cox proportional hazard model. Results History of injecting drug use behavior (hazard ratio (HR): 2.26, P = 0.042), illicit benzodiazepine consumption (HR: 1.07, P = 0.002), and the age of onset of opioid abuse (HR: 1.10, P < 0.0001) are important indicators of accelerated relapse among MMT patients. Conversely, current age is positively associated with duration of abstinence from illicit opioid use, serving as a protective factor against relapse (HR: 0.93, P = 0.003). Conclusion This study helps to identify patients at increased risk of relapse during MMT, allowing health care providers to target more aggressive adjunct therapies toward high-risk patients.

Publisher

SAGE Publications

Subject

Psychiatry and Mental health

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