Opioid agonist treatment is commonly initiated as a first-line treatment for individuals with pharmaceutical opioid dependence, even though much of the evidence base for the use of pharmacotherapy treatments in opioid dependence has been derived from studies conducted with primarily or exclusively heroin-dependent samples. Users of pharmaceutical opioids have been described in the literature to be a different patient population with a number of characteristics that differ from heroin-using populations, including having a higher prevalence of physical and mental health co-morbidities. Prescription opioid dependence has been described to be at epidemic levels in the USA and has been reported to be increasing globally. Establishing an evidence base for treatment of prescription opioid dependence is therefore timely and critical.
This project is a series of secondary data analysis being conducted as part of a NHMRC Early Career Fellowship. Using data from a series of randomised controlled trials we compared different aspects of treatment for heroin and prescription opioid users to better understand the unique treatment needs and treatment outcomes for pharmaceutical opioid users.
To enhance the evidence base for treatment of pharmaceutical opioid dependence.
Secondary data analysis from clinical trials that recruited both heroin and pharmaceutical opioid users.
A series of publications has added to the current knowledge of providing opioid pharmacotherapy for pharmaceutical opioid users.
Papers:
Nielsen S, Larance B, Degenhardt L, Gowing L, Kehler C, Lintzeris N., Opioid agonist treatment for pharmaceutical opioid dependent people. Cochrane Database of Systematic Reviews, 2016. CD011117 (5)
Nielsen S, Hillhouse M, Mooney L, Ang, A. & Ling W. Buprenorphine Pharmacotherapy and Behavioral Treatment: Comparison of Outcomes among Prescription Opioid Users, Heroin Users and Combination users. Journal of Substance Abuse Treatment. 2015;48(1):70-6.
Nielsen, S., Hillhouse, M., Weiss, R. D., Mooney, L., Sharpe Potter, J., Lee, J., Gourevitch, M. N. and Ling, W. (2014), The relationship between primary prescription opioid and buprenorphine–naloxone induction outcomes in a prescription opioid dependent sample. The American Journal on Addictions, 23(4): 343–348. doi: 10.1111/j.1521-0391.2013.12105.x
Potter, J.S., Marino. E., Hillhouse, M., Nielsen, S., Wiest, K., Canamar, C, Martin, J., Ang, A., Baker, R., Saxon, A. & Ling, W. (2013) Buprenorphine and methadone maintenance treatment outcomes for opioid analgesic, heroin, and combined users: Findings from Starting Treatment with Agonist Replacement Therapies (START). Journal of Studies on Alcohol and Drugs. 74(4): 605-13.
Nielsen, S., Hillhouse, M., Thomas, C., Hasson, A., Ling, W (2013). A comparison of buprenorphine taper outcomes between prescription opioid and heroin users. Journal of Addiction Medicine. 7(1):33-8. doi: 10.1097/ADM.0b013e318277e92e
Nielsen, S.,Hillhouse, M., Mooney, L., Fahey, J. & Ling. W. (2012) Comparing buprenorphine induction experience with heroin and prescription opioid users. Journal of Substance Abuse Treatment. 43(3):285-90. doi: 10.1016/j.jsat.2011.12.009
This project will contribute to the understanding pharmacotherapy treatment for pharmaceutical opioid dependence.