Participants in the Remission from Chronic Opioid Use, Studying Environmental and SocioEconomic Factors on Recovery (RECOVER; ClinicalTrials identifier: NCT03604861) study reported positive outcomes, including high opioid abstinence, according to findings published in the Journal of Addiction Medicine.
Efforts to combat the opioid epidemic have primarily focused on the promotion of overdose-reversing medications. However, little is known about the long-term outcomes of pharmacotherapy for opioid use disorder (OUD). In this 24-month observational study, researchers sought to capture 12-month outcomes from individuals who had previously participated in a buprenorphine extended-release subcutaneous injection (BUP-XR) trial.
Participants were asked to complete detailed self-administered assessments concerning substance use, treatment for substance use disorder, and psychosocial measures. Researchers assessed sustained opioid abstinence over the course of 12 months and self-reported past-week abstinence at 3-, 6-, 9-, and 12-month visits. In addition, pain, withdrawal, health-related quality of life, employment, and depression at RECOVER baseline and 12-month visits were compared with values collected before treatment in the BUP-XR trial.
Overall, 425 participants from 35 community-based sites in the United States completed the study (mean age, 42 years; 66% male). The results revealed that half (50.8%) of participants had sustained 12-month abstinence, whereas 68.0% reported past-week abstinence. In multiple regression analysis, longer BUP-XR treatment duration and being female were associated with sustained 12-month abstinence.
Moreover, participants receiving 12-month vs 2-month BUP-XR treatment duration had significantly increased probability of sustained opioid abstinence (75.3% vs 24.1%; P =.001), with comparable results for past-week self-reported abstinence over time. Patients experienced reduced withdrawal symptoms, positive health-related quality of life, minimal depression, and lower pain scores during RECOVER vs pretrial visit.
Limitations of the study included confounding factors resulting from the lack of randomization to treatment duration in the BUP-XR trial, which could have an effect on abstinence and other outcomes in the RECOVER study. Generalizability of the results may be limited, as all RECOVER participants had previously participated in the BUP-XR trial.
The results provide insights into the underlying causes of relapse and can be used to gain further understanding of the long-term effect of pharmacotherapy for sustained OUD recovery. “The US Food and Drug Administration notes that these sustained-release buprenorphine products not only provide effective treatment, but also can decrease misuse, abuse, and accidental exposure to buprenorphine as compared to self-administered formulations,” the researchers concluded.
Ling W, Nadipelli VR, Aldridge AP, Ronquest NA, Solem CT, Chilcoat H. Recovery from opioid use disorder (OUD) after monthly long-acting buprenorphine treatment:12-month longitudinal outcomes from RECOVER, an observational study [published online March 13, 2020]. J Addict Med. doi:10.1097/ADM.0000000000000647