A Comparison of Cigarette Smoking Profiles in Opioid-Dependent Pregnant Patients Receiving Methadone or Buprenorphine
A Comparison of Cigarette Smoking Profiles in Opioid-Dependent Pregnant Patients Receiving Methadone or Buprenorphine
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DOI：
10.1093/ntr/nts274
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发表时间：
2013-07-01
影响因子：
4.7
通讯作者：
Jones, Hendree E.
中科院分区：
文献类型：
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作者：
Chisolm, Margaret S.;Fitzsimons, Heather;Jones, Hendree E.
对阿片类药物依赖孕妇吸烟与激动剂治疗之间的关系知之甚少。本研究的目的是检查接受双盲美沙酮或丁丙诺啡的阿片类药物依赖患者在怀孕期间吸烟情况的差异改变程度。患者是国际随机对照孕产妇阿片类药物治疗：人类实验研究（MOTHER）研究的参与者。在2005年至2008年期间完成了美沙酮（67例）和丁丙诺啡（57例）的多地点、双盲、双假、随机对照试验的阿片类药物维持妊娠患者（1841岁），有吸烟数据。根据阿片类激动剂治疗条件，比较参与者的吸烟变量。总体而言，95%的样本报告在治疗开始时吸烟。两种药物治疗条件下的参与者在前处理特征上相似，包括吸烟率和每日吸烟量。在整个怀孕过程中，两种药物都没有观察到吸烟的有意义的变化。两种情况下调整后的每日卷烟量变化的拟合差异很小且不显著（0.08,SE 0.05, p .132）。研究结果支持阿片类药物依赖患者怀孕期间的高吸烟率几乎没有变化，无论接受何种激动剂药物。这些发现与尼古丁效应的证据一致，丁丙诺啡与美沙酮的相互作用可能相似。结果进一步强调，需要积极努力减少/消除阿片类药物依赖孕妇的吸烟。
Little is known about the relationship between cigarette smoking and agonist treatment in opioid-dependent pregnant patients. The objective of this study is to examine the extent to which cigarette smoking profiles differentially changed during the course of pregnancy in opioid-dependent patients receiving either double-blind methadone or buprenorphine. Patients were participants in the international, randomized controlled Maternal Opioid Treatment: Human Experimental Research (MOTHER) study.A sample of opioid-maintained pregnant patients (1841 years old) with available smoking data who completed a multisite, double-blind, double-dummy, randomized controlled trial of methadone (n 67) and buprenorphine (n 57) between 2005 and 2008. Participants were compared on smoking variables based on opioid agonist treatment condition.Overall, 95% of the sample reported cigarette smoking at treatment entry. Participants in the two medication conditions were similar on pretreatment characteristics including smoking rates and daily cigarette amounts. Over the course of the pregnancy, no meaningful changes in cigarette smoking were observed for either medication condition. The fitted difference in change in adjusted cigarettes per day between the two conditions was small and nonsignificant ( 0.08, SE 0.05, p .132).Results support high rates of smoking with little change during pregnancy among opioid-dependent patients, regardless of the type of agonist medication received. These findings are consistent with evidence that suggests nicotine effects, and interactions may be similar for buprenorphine compared with methadone. The outcomes further highlight that aggressive efforts are needed to reduce/eliminate smoking in opioid-dependent pregnant women.