Opioid Use Disorder Research Roundup: April 19, 2024

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In this Research Roundup, we explore new studies on comorbidities, addictive behaviors, and the efficacy of telemedicine associated with the treatment of opioid use disorder.

ADHD Symptoms and Problematic Internet Use in Patients With OUD

This study investigated symptoms of attention-deficit/hyperactivity disorder (ADHD) and impulsivity in individuals diagnosed with opioid use disorder (OUD) who also display symptoms of problematic internet use (PIU). Among 360 patients with OUD at an addiction treatment center, those with PIU showed high levels of depression, anxiety, and ADHD symptoms, as indicated by assessment scores.

“These findings highlight the importance of addressing PIU and comorbidities in OUD treatment,” the investigators concluded. “Interventions targeting ADHD symptoms and emotional well-being may benefit PIU management.”

Reference

Bal NB, Örnek BY. Comparison of opioid use disorder patients with and without problematic internet use in terms of impulsivity and attention deficit hyperactivity disorder. Braz J Psychiatry. Published online April 18, 2024.

Identifying Problematic Opioid Use With Natural Language Processing vs Diagnostic Codes

This study devised a natural language processing (NLP) tool to detect problematic opioid use from clinical notes in electronic health records and contrasted it with conventional diagnostic code-based identification. The NLP tool attained impressive metrics, with 96.6% specificity, 90.4% precision/positive predictive value (PPV), 88.4% sensitivity/recall, and 94.4% accuracy on unseen test data. Notably, NLP exclusively pinpointed 57,331 patients, whereas 6997 patients were identified solely through International Classification of Diseases (ICD) codes.

Patients identified solely via NLP were predominantly women, while those through ICD codes tended to be male, younger, with concurrent benzodiazepine prescriptions, more comorbidities, and more care encounters, yet less likely to be married. The investigators concluded that these findings underscore the necessity for a comprehensive approach to identify opioid-related concerns in health care settings.

Reference

Workman TE, Kupersmith J, Ma P, et al. A comparison of veterans with problematic opioid use identified through natural language processing of clinical notes versus using diagnostic codes. Healthcare (Basel). 2024;12(7):799.

Telemedicine for OUD Medication and HIV Pre-Exposure Prophylaxis

This study piloted PARTNER UP, a telemedicine program providing individuals who inject drugs with medication for OUD using buprenorphine/naloxone (bup/nx) and oral pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate/emtricitabine through 2 syringe services programs (SSP). Among 17 enrolled participants, 76% remained in the study at 3 months, with 77% continuing both medication for OUD and PrEP, whereas at 6 months, 71% remained, with 67% adhering to both medications.

Self-reported daily adherence to PrEP declined over time, with low perception of HIV risk cited as a common reason for discontinuation. The investigators concluded that these results suggest the need for tailored interventions to promote PrEP adherence among individuals who inject drugs.

Reference

McKellar MS, Des Marais AC, Chen H, et al. Providing medication for opioid use disorder and HIV pre-exposure prophylaxis at syringe services programs via telemedicine: a pilot study. Harm Reduct J. 2024;21(1):69.

Note: This Research Roundup was prepared with the assistance of ChatGPT.

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