Opioid Use Disorder Treatments: An Evidence Map. (1st December 2022)

• Record Type: Journal Article
• Authors: Sugarman, Allison; Vittitow, Alexandria; Cheng, Anna; Malone, Mia; McDonald, Ryan; Pace, Nancy; Williams, Ololade; Tofighi, Babak; McNeely, Jennifer; Schatz, Daniel; Roberts, Timothy; Hey, Spencer Phillips; Garrity, Kathleen; Lindquist, Kristin; Lee, Joshua D.
• Is Part Of: Drug and alcohol dependence. Volume 241(2022)
• Publication Date: 2022-12-01
• Subjects: Evidence map -- Opioid use disorder -- Buprenorphine -- Methadone; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2022.109657
• Languages: English
• ISSNs: 0376-8716

Abstract

Abstract: Background: Evidence maps are emerging data visualization of a systematic review. There are no published evidence maps summarizing opioid use disorder (OUD) interventions. Aim: Our aim was to publish an interactive summary of all peer-reviewed interventional and observational trials assessing the treatment of OUD and common clinical outcomes. Methods: PubMed, Embase, PsycInfo, Cochrane Central Register of Clinical Trials, and Web of Science were queried using multiple OUD-related MESH terms, without date limitations, for English-language publications. Inclusions were human subjects, treatment of OUD, OUD patient or community-level outcomes, and systematic reviews of OUD interventions. Exclusions were laboratory studies, reviews, and case reports. Two reviewers independently scanned abstracts for inclusion before coding eligible full-text articles by pre-specified filters: research design, study population, study setting, intervention, outcomes, sample size, study duration, geographical region, and funding sources. Results: The OUD Evidence Map (https://med.nyu.edu/research/lee-lab/research/opioid-use-disorder-treatment-evidence-map) identified and assessed 12, 933 relevant abstracts through 2020. We excluded 9455 abstracts and full text reviewed 2839 manuscripts; 888 were excluded, 1591 were included in the final evidence map. The most studied OUD interventions were methadone (n = 754 studies), buprenorphine (n = 499), and naltrexone (n = 134). The most common outcomes were heroin/opioid use (n = 708), treatment retention (n = 557), and non-opioid drug use (n = 368). Clear gaps included a wider array of opioid agonists for treatment, digital behavioral interventions, studies of OUD treatments in criminal justice settings, and overdose as a clinical outcome. Conclusion: This OUD Evidence Map highlights the importance of pharmacologic interventions for OUD and reductions in opioid use. Future iterations will update results annually and scan policy-level interventions. Highlights: This opioid use disorder (OUD) evidence map allows researchers and clinicians to rapidly survey the entirety of the OUD literature through a publicly available digital resource. The most well-studied OUD interventions to date are methadone, buprenorphine, and naltrexone medication treatments. Evidence gaps include opioid agonist therapies other than buprenorphine and methadonesuch as hydromorphone.