Using ecological momentary assessment to examine the relationship between craving and affect with opioid use in a clinical trial of clonidine as an adjunct medication to buprenorphine treatment.
Using ecological momentary assessment to examine the relationship between craving and affect with opioid use in a clinical trial of clonidine as an adjunct medication to buprenorphine treatment.
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DOI：
10.1080/00952990.2018.1454933
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Preston KL
中科院分区：
文献类型：
--
作者：
Kowalczyk WJ;Moran LM;Bertz JW;Phillips KA;Ghitza UE;Vahabzadeh M;Lin JL;Epstein DH;Preston KL
在最近的一项临床试验（NCT 00295308）中，我们证明了可乐定降低了接受丁丙诺啡类阿片受体激动剂治疗的患者中阿片类药物渴求与中度压力和影响之间的相关性。在评价可乐定作为丁丙诺啡治疗阿片类药物使用障碍的辅助药物期间，检查非法阿片类药物使用与渴求和情感之间的关系。其次，检查这些关系是否由参与者内部或参与者之间的因素驱动。这是我们原始试验的次要数据分析。接受丁丙诺啡的参与者（N = 108，女性：n = 23，男性n =85）随机接受可乐定或安慰剂辅助治疗。参与者使用便携式电子设备通过生态瞬时评估（EMA）每天随机四次对压力，情绪和渴望进行评级。为了将EMA数据与非法阿片类药物使用相关联，每个EMA报告都与参与者的下一次尿液药物筛查（每周三次）相关联。我们使用广义线性混合模型来研究治疗组和非法阿片类药物使用之间的相互作用，并将分析分解为参与者内和参与者间的影响。当参与者使用非法阿片类药物时，对阿片类药物和可卡因的渴望增加;可乐定组的这种影响更大。对于影响，在阿片样物质阳性尿液之前的时期，可乐定治疗的参与者的情绪比阿片样物质阴性尿液更差，而安慰剂参与者没有差异。该次要分析提供的证据表明，在阿片类激动剂治疗中，非法阿片类药物使用与维持可乐定的参与者中更强烈的负面影响和渴望有关。
In a recent clinical trial (NCT00295308), we demonstrated that clonidine decreased the association between opioid craving and moderate levels of stress and affect in patients receiving buprenorphine-based opioid agonist therapy. To examine the relationship between illicit opioid use and craving and affect during the evaluation of clonidine as an adjunct medication in buprenorphine treatment for opioid use disorder. Secondarily, to examine whether those relationships are driven by within- or between-participant factors. This was a secondary data analysis from our original trial. Participants (N = 108, female: n = 23, male n =85) receiving buprenorphine were randomized to receive adjunct clonidine or placebo. Participants used portable electronic devices to rate stress, mood, and craving via ecological momentary assessment (EMA) four times randomly each day. To associate the EMA data with illicit opioid use, each EMA report was linked to participants’ next urine drug screen (thrice weekly). We used generalized linear mixed models to examine the interaction between treatment group and illicit opioid use, as well as to decompose the analysis into within- and between-participant effects. Craving for opioids and cocaine was increased when participants were using illicit opioids; this effect was greater in the clonidine group. For affect, mood was poorer during periods preceding opioid-positive urines than opioid-negative urines for clonidine-treated participants, whereas there was no difference for placebo participants. This secondary analysis provides evidence that illicit opioid use was linked to stronger negative affect and craving in participants maintained on clonidine in opioid agonist therapy.
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3.4
作者：
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