Factors associated with using opiates while under extended-release naltrexone blockade: A descriptive pilot study
Factors associated with using opiates while under extended-release naltrexone blockade: A descriptive pilot study
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DOI：
10.1016/j.jsat.2016.12.006
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发表时间：
2018-02-01
影响因子：
3.9
通讯作者：
Silverman, Kenneth
中科院分区：
文献类型：
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作者：
Jarvis, Brantley P.;DeFulio, Anthony;Silverman, Kenneth
背景和目的：缓释纳曲酮 (XR-NTX) 可阻断阿片类药物的作用 4 周，但许多患者仍在继续使用它们。为了更多地了解发生这种情况的原因，我们收集了参与者在 XR-NTX 封锁期间最近使用海洛因/阿片类药物的主观影响和药物使用因素的自我报告。方法：参与者 (n = 38) 是失业的海洛因依赖成年人，参加了一项随机对照试验，评估基于就业的激励措施，以促进对 XR-NTX 的依从性。一部分参与者 (n = 18) 被要求完成一项关于他们最近使用海洛因/阿片类药物的调查，他们在 XR-NTX 封锁期间提供阿片类药物呈阳性的尿液样本。每周进行一次调查，参与者可以在整个试验过程中完成多项调查。参与者报告了他们的水平有多高（11分制；0 =完全没有，10 =非常），他们服用了多少海洛因/阿片剂（在开始纳曲酮之前与平常相比更少，更多或大致相同），他们是否同时使用可卡因，以及海洛因/阿片剂和可卡因的给药途径（如果使用）。所有分析均为描述性的。结果：在 107 项调查中，75.7% 的受访者表示上次使用海洛因/阿片类药物时“一点也不”高。 75.5% 的调查报告阿片类药物数量低于平常，只有 7.5% 的调查报告数量高于平常。 57.9% 的调查中，可卡因与海洛因同时使用，但通常通过不同途径 (74.2%)。 讨论：在 XR-NTX 封锁期间使用海洛因/阿片类药物与自我报告的高浓度、服用超过正常量的阿片类药物或通过同一途径同时服用阿片类药物和可卡因并无密切关系。未来的研究应结合纳曲酮浓度的测量以及使用生态瞬时评估进行更全面和更频繁的评估。 (C) 2017 Elsevier Inc. 保留所有权利。
Background and aim: Extended-release naltrexone (XR-NTX) blocks the effects of opioids for 4 weeks, yet many patients continue to use them. To learn more about why this occurs, we collected self-reports on subjective effects and drug use factors from participants' most recent heroin/opiate use while under XR-NTX blockade.Methods: Participants (n = 38) were unemployed, heroin-dependent adults enrolled in a randomized controlled trial evaluating employment-based incentives to promote adherence to XR-NTX. A subset of participants (n = 18) were asked to complete a survey about their most recent use of heroin/opiates when they provided an opiate-positive urine sample while under XR-NTX blockade. Surveys were administered weekly, and participants could complete multiple surveys throughout the trial. Participants reported how high they were (11-point scale; 0 = not at all, 10 = extremely), how much heroin/opiates they took (less, more, or about the same as usual before starting naltrexone), whether they used cocaine at the same time, and the routes of administration for heroin/opiates and cocaine (if used). All analyses were descriptive.Results: Of the 107 surveys, 75.7% indicated being "not at all" high the last time heroin/opiates were used. 75.5% of surveys reported opiate amounts that were less than usual, and only 7.5% reported amounts larger than usual. Cocaine was used at the same time as heroin for 57.9% of surveys but typically through a different route (74.2%).Discussion: Using heroin/opiates while under XR-NTX blockade is not strongly associated with self-reports of high, taking larger than normal amounts of opiates, or taking opiates and cocaine simultaneously via the same route. Future research should incorporate measures of naltrexone concentration and more comprehensive and frequent assessments using ecological momentary assessment. (C) 2017 Elsevier Inc. All rights reserved.