Pre-Existing Psychiatric Severity Did Not Affect Likelihood of Success in the Prescription Opiate Addiction Treatment Study (POATS)
Year of Publication
Sparenborg, S; Hu, L; Sharpe Potter, J; Weiss, R
College on Problems of Drug Dependence 74th Annual Meeting
Palm Springs, CA
Aims: Psychiatric co-morbidities have been positively associated with severe opiate use and decreased probability of success in treatment for opiate addictions. The POATS, a multisite, randomized controlled trial conducted by the Clinical Trials Network of NIDA presents the first opportunity to evaluate the influence of psychiatric co-morbidities on treatment retention and outcome in patients addicted to prescription opiates. Methods: The Addiction Severity Index Lite (ASI) was given to all 653 patients at baseline in the POATS study. All patients were treated with buprenorphine-naloxone and standard medical management, with half also receiving opioid dependence counseling. The dichotomous succeed/fail primary outcome was predefined as a composite of reduction in opiate use and completion of treatment. Proportions of successes and failures were compared to the Psychiatric Status (PS) domain of the ASI using 1) the TRI Composite score, 2) questions P1 or P2 for history of mental health treatment, and 3) questions P13 and P14 to capture concern regarding symptoms in the 30 days before randomization using Chi square and linear regression methods. Results: One-third of all POATS patients reported psychiatric problems in the ASI. 220 patients in the POATS study were successes and 433 were failures. The proportions of successful and failing patients were not related to the PS composite score or to past treatment for mental health problems (P1 or P2). A greater proportion of successful patients were concerned about recent symptoms and desired to receive treatment for these symptoms than failing patients (p < .02; P13 and P14). Conclusions: The self-reported psychiatric severity of POATS patients did not affect their likelihood of treatment success, but successful patients tended to express more concern about their psychiatric symptoms.