Smokers with opioid use disorder may have worse drug use outcomes after varenicline than nicotine replacement
- PMID:31370981
- PMCID: PMC6684327
- DOI: 10.1016/j.jsat.2019.06.005
Smokers with opioid use disorder may have worse drug use outcomes after varenicline than nicotine replacement
Abstract
Introduction: Smokers with opioid use disorder (OUD) have little success with smoking cessation, possibly due to interactions between nicotine and opioid receptor systems. Smokers with OUD versus non-opioid substance use disorders (NOUD) have not been compared for response to smoking treatment. Data to make this comparison came from our previous study of 12 weeks (plus dose run-up) of varenicline (VAR) versus 12 weeks of nicotine patch (NRT), in a double-placebo design.
Methods: The current study reports secondary analyses comparing smokers with OUD (n = 47) and NOUD (n = 90) on pretreatment smoking, alcohol and drug use, intolerance of physical discomfort, smoking medication adherence, and 3- and 6-month smoking and substance use outcomes (by VAR versus NRT).
Results: Smokers with OUD did not differ on pretreatment alcohol or smoking measures while reporting significantly more drug use days. Smokers with OUD versus NOUD had significantly fewer days adherent to VAR or placebo capsules but not to patches, and were more tolerant of physical discomfort. While smoking and heavy drinking days at follow-ups did not differ by diagnosis, smokers with OUD had significantly more drug use days in months 4-6 when assigned to VAR (16.4 days) than to NRT (8.1 days).
Conclusions: NRT might be a better choice than VAR for smokers with OUD due to lower adherence and more drug use days with VAR. However, this novel comparison of smoking pharmacotherapy response in smokers with OUD versus NOUD needs to be confirmed with larger numbers of participants.
Keywords: Opioid use disorder; Smoking treatment; Substance use disorder; Tolerance for discomfort; Transdermal nicotine; Varenicline.
Published by Elsevier Inc.
Conflict of interest statement
Conflict of interest declaration: All authors report no financial interests or potential conflicts of interest.
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References
- Anthenelli RM, Benowitz NL, West R, St Aubin L, McRae T, Lawrence D, … Evins EA (2016). Neuropsychiatric safety and efficacy of varenicline, bupropion, and nicotine patch in smokers with and without psychiatric disorders (EAGLES): A double-blind, randomized, placebo-controlled clinical trial. The Lancet, 387, 2507–2520. - PubMed
- Baxley C, Weinstock J, Lustman PJ, & Garner AA (2019). The influence of anxiety sensitivity on opioid use disorder treatment outcomes. Experimental and Clinical Psychopharmacology, 27, 64–67. - PubMed
- Brown RA, Burgess ES, Sales SD, Whiteley JA, Evans DM, & Miller IW (1998). Reliability and validity of a smoking timeline follow-back interview. Psychology of Addictive Behaviors, 12, 101–112.
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