Lower buprenorphine elimination rate constant is associated with lower opioid use

Background Opioid craving is suggested to correlate with the rate of reduction in buprenorphine (BUP) plasma levels. No studies explored Buprenorphine elimination rate constant (BUP EL.R) as a predictor of opioid use or retention in BUP treatment. Methods Analysis was performed using data from a ran...

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Bibliographic Details
Published in:Psychopharmacology 2022-10, Vol.239 (10), p.3213-3221
Main Authors: Elarabi, Hesham Farouk, Lee, Amanda J., Adem, Abdu, Elrasheed, Abuelgasim, Marsden, John, Al Ghaferi, Hamad
Format: Article
Language:English
Subjects:
Adult
Analgesics, Opioid - therapeutic use
Biomedical and Life Sciences
Biomedicine
Buprenorphine
Buprenorphine - therapeutic use
Dosage and administration
Drug abuse
Drug addiction
Drug dosages
Drug metabolism
Drug screening
Health aspects
Humans
Narcotic Antagonists - therapeutic use
Narcotics
Neurosciences
Opioid-Related Disorders - drug therapy
Opioids
Original Investigation
Pharmacology/Toxicology
Plasma levels
Precision medicine
Psychiatry
Testing
Therapeutic drug monitoring
Treatment Outcome
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Summary:Background Opioid craving is suggested to correlate with the rate of reduction in buprenorphine (BUP) plasma levels. No studies explored Buprenorphine elimination rate constant (BUP EL.R) as a predictor of opioid use or retention in BUP treatment. Methods Analysis was performed using data from a randomized controlled trial of 141 adults with opioid use disorder (OUD) randomized to Incentivized Adherence and Abstinence monitoring (I-AAM; experimental ( n  = 70) and treatment-as-usual; control ( n  = 71). In the I-AAM, structured access to unsupervised BUP doses was provided up to 28 days contingent of adherence measured by Therapeutic Drug Monitoring and abstinence by Urinary Drug Screens (UDS). In contrast, the treatment-as-usual (control) provided unstructured access to unsupervised doses was provided for up to 14 days considering UDS results. The primary outcome was percentage negative UDS. The secondary outcome, retention in treatment, was continuous enrollment in the study and analysis was via intention-to-treat. Significant bivariate correlations with the outcomes were adjusted for group allocation. Results A significant negative correlation between BUP EL.R and percentage negative opioid screens (Pearson correlation coefficient − 0.57, p  
ISSN:0033-3158
1432-2072
DOI:10.1007/s00213-022-06202-9