The Influence of Anxiety Sensitivity on Opioid Use Disorder Treatment Outcomes
The Influence of Anxiety Sensitivity on Opioid Use Disorder Treatment Outcomes
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DOI：
10.1037/pha0000215
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发表时间：
2019-02-01
影响因子：
2.3
通讯作者：
Garner, Annie A.
中科院分区：
文献类型：
--
作者：
Baxley, Catherine;Weinstock, Jeremiah;Garner, Annie A.
鉴于阿片类药物使用障碍（OUD）患者的复发率很高，确定负面治疗结果的可改变风险因素至关重要。焦虑敏感性（AS）是一个可能与OUD治疗结果呈负相关的风险因素。本研究探讨了AS对OUD患者戒断过程、后续治疗参与和复发的潜在影响。接受住院戒毒的成人（N = 90）在为期5天的丁丙诺啡辅助戒毒方案的第4天完成了自我报告和研究人员管理的问卷调查，1个月后进行了随访评估，评估了治疗参与和复发。虽然68%的样本参与了后续治疗，但76%的样本依从性较差。超过一半的样本（57%）在1个月后报告阿片类药物复发。结果显示，更大的AS和年轻的年龄预测更大的恐惧戒断过程中的解毒。与研究假设相反，AS不是其他治疗结果的重要预测因素;相反，对戒断的恐惧和阿片类药物脱毒的先前数量预测了更大的主观戒断严重程度。在戒毒过程中，年龄较小与更大的渴望有关，男性与接受处方抗焦虑药的可能性更高有关。戒毒治疗后，转诊到住院治疗预测更大的治疗参与，而更大的阿片类药物的渴望，在不受控制的环境中的天数，以及出院后使用任何非阿片类药物预测更大的阿片类药物复发。未能找到AS和戒断过程之间的关系可能是丁丙诺啡方案的一个功能。总体而言，研究结果可能对OUD的治疗具有重要意义。
Given the high rates of relapse among patients with opioid use disorder (OUD), it is crucial to identify modifiable risk factors for negative treatment outcomes. Anxiety sensitivity (AS) is 1 such risk factor that may be associated with negative OUD treatment outcomes. The present study examined the potential impact of AS on the withdrawal process, subsequent treatment engagement, and relapse among individuals with OUD. Adults undergoing inpatient detoxification (N = 90) completed self-report and researcher-administered questionnaires on Day 4 of a 5-day buprenorphine-assisted detoxification protocol, and 1 month later a follow-up evaluation assessed treatment engagement and relapse. Although 68% of the sample engaged in subsequent treatment, 76% demonstrated poor adherence. Over half the sample (57%) reported opioid relapse 1 month later. Results revealed that greater AS and younger age predicted greater fear of withdrawal during detoxification. Contrary to the research hypotheses, AS was not a significant predictor of other treatment outcomes; rather, fear of withdrawal and prior number of opioid detoxifications predicted greater subjective withdrawal severity. During detoxification, younger age was related to greater cravings, and being a male was associated with a higher likelihood of receiving prescription anxiolytics. Following detoxification treatment, referral to residential treatment predicted greater treatment engagement, whereas greater opioid craving, number of days in an uncontrolled environment, and any nonopioid substance use postdischarge predicted greater opioid relapse. Failure to find a relationship between AS and the withdrawal process is potentially a function of the buprenorphine protocol. Overall, findings may have important implications for the treatment of OUD.