Assessment of Co-Occurring Substance Use During Opiate Treatment Programs in the United States. Issue 1 (16th October 2020)

• Record Type: Journal Article
• Authors: Gormley, Mirinda Ann; Blondino, Courtney T; Taylor, DaShaunda D H; Lowery, Elizabeth; Clifford, James S; Burkart, Benjamin; Graves, Whitney C; Prom-Wormley, Elizabeth C; Lu, Juan
• Is Part Of: Epidemiologic reviews. Volume 42:Issue 1(2020)
• Page Start: 79
• Page End: 102
• Publication Date: 2020-10-16
• Subjects: analgesics -- opioids -- patient compliance -- patient dropout -- substance abuse detection -- treatment outcome; Epidemiology -- Periodicals; 614.405
• DOI: 10.1093/epirev/mxaa009
• Languages: English
• ISSNs: 0193-936X

Abstract

Abstract: The effectiveness of opiate treatment programs (OTPs) can be significantly influenced by co-occurring substance use, yet there are no standardized guidelines for assessing the influence of co-occurring substance use on treatment outcomes. In this review, we aim to provide an overview on the status of the assessment of co-occurring substance use during participation in OTPs in the United States. We searched 4 databases—MEDLINE/PubMed, EMBASE, PsychINFO, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL)—from database inception to November 2018 to select relevant publications on OTPs that assessed participants' co-occurring substance use. We used a standardized protocol to extract study, intervention, and co-occurring substance use characteristics. Methodological quality was assessed using the Quality in Prognosis Studies tool. Of the 3, 219 titles screened, 614 abstracts and 191 full-text original publications were assessed, leaving 85 eligible articles. Co-occurring substance use was most often assessed during opioid treatments using combined (pharmacological and behavioral) ( n = 57 studies) and pharmacological ( n = 25 studies) interventions. Cocaine, alcohol, marijuana, and benzodiazepines were frequently measured, while amphetamines and tobacco were rarely assessed. Great variation existed between studies in the timing and measurement of co-occurring substance use, as well as definitions for substances and polysubstance/polydrug use. Inconsistencies in the investigation of co-occurring substance use make comparison of results across studies challenging. Standardized measures and consensus on research on co-occurring substance use is needed to produce the evidence required to develop personalized treatment programs for persons using multiple substances and to inform best-practice guidelines for addressing polydrug use during participation in OTPs.