Beneficial Effects of Opioid Rotation to Buprenorphine/Naloxone on Opioid Misuse, Craving, Mental Health, and Pain Control in Chronic Non-Cancer Pain Patients with Opioid Use Disorder
Patients with chronic non-cancer pain (CNCP) often use opioids for long periods of time. This may lead to opioid use disorder (OUD) and psychiatric symptoms: mainly depression and anxiety. The current study investigated the effect of buprenorphine/naloxone (BuNa) rotation on opioid misuse, craving,...
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MDPI AG
2021-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/16/3727 |
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| author | Arnt F. A. Schellekens Stijn E. Veldman Eka S. D. Suranto Steffie M. van Rijswijk Selina E. I. van der Wal Aart H. Schene Marleen H. C. T. van Beek |
| author_facet | Arnt F. A. Schellekens Stijn E. Veldman Eka S. D. Suranto Steffie M. van Rijswijk Selina E. I. van der Wal Aart H. Schene Marleen H. C. T. van Beek |
| author_sort | Arnt F. A. Schellekens |
| collection | DOAJ |
| description | Patients with chronic non-cancer pain (CNCP) often use opioids for long periods of time. This may lead to opioid use disorder (OUD) and psychiatric symptoms: mainly depression and anxiety. The current study investigated the effect of buprenorphine/naloxone (BuNa) rotation on opioid misuse, craving, psychiatric symptoms and pain in patients with CNCP and OUD. Forty-three participants with CNCP and OUD were converted from a full mu-receptor agonist opioid (mean morphine equivalent dose: 328.3 mg) to BuNa, in an inpatient setting. Opioid misuse, craving, co-occurring psychiatric symptoms, and pain perception were determined at baseline and after a two-month follow-up, using the following self-report questionnaires: Current Opioid Misuse Measurement (COMM), Visual Analog Scale (VAS-craving and VAS-pain) and Depression, Anxiety and Stress Scale (DASS), respectively. VAS-craving and VAS-pain were also determined immediately after conversion. A total of 37 participants completed the protocol. The mean COMM decreased from 17.1 to 6.7 (F = 36.5; <i>p</i> < 0.000), the mean VAS-craving decreased from 39.3 to 5.3 (−86.6%; F = 26.5, <i>p</i> < 0.000), the mean DASS decreased from 12.1 to 6.6 (F = 56.3, <i>p</i> < 0.000), and the mean VAS-pain decreased from 51.3 to 37.2 (−27.4%, F = 3.3; <i>p</i> = 0.043). Rotation to BuNa in patients with CNCP and OUD was accompanied by reductions in (i) opioid misuse, (ii) opioid craving, (iii) the severity of co-occurring psychiatric symptoms, and (iv) self-reported pain. BuNa as opioid agonist treatment may therefore be a beneficial strategy in CNCP patients with OUD. The limited sample size and the observational nature of this study underline the need for the replication of the current findings in large-scale, controlled studies. |
| first_indexed | 2024-03-10T08:42:01Z |
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| last_indexed | 2024-03-10T08:42:01Z |
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| spelling | doaj.art-7511e150b87b47dbab4e5cb4053cf7872023-11-22T08:12:42ZengMDPI AGJournal of Clinical Medicine2077-03832021-08-011016372710.3390/jcm10163727Beneficial Effects of Opioid Rotation to Buprenorphine/Naloxone on Opioid Misuse, Craving, Mental Health, and Pain Control in Chronic Non-Cancer Pain Patients with Opioid Use DisorderArnt F. A. Schellekens0Stijn E. Veldman1Eka S. D. Suranto2Steffie M. van Rijswijk3Selina E. I. van der Wal4Aart H. Schene5Marleen H. C. T. van Beek6Department of Psychiatry, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The NetherlandsDepartment of Psychiatry, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The NetherlandsDepartment of Psychiatry, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The NetherlandsDepartment of Psychiatry, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The NetherlandsDepartment of Anesthesiology Pain and Palliative Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The NetherlandsDepartment of Psychiatry, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The NetherlandsDepartment of Psychiatry, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The NetherlandsPatients with chronic non-cancer pain (CNCP) often use opioids for long periods of time. This may lead to opioid use disorder (OUD) and psychiatric symptoms: mainly depression and anxiety. The current study investigated the effect of buprenorphine/naloxone (BuNa) rotation on opioid misuse, craving, psychiatric symptoms and pain in patients with CNCP and OUD. Forty-three participants with CNCP and OUD were converted from a full mu-receptor agonist opioid (mean morphine equivalent dose: 328.3 mg) to BuNa, in an inpatient setting. Opioid misuse, craving, co-occurring psychiatric symptoms, and pain perception were determined at baseline and after a two-month follow-up, using the following self-report questionnaires: Current Opioid Misuse Measurement (COMM), Visual Analog Scale (VAS-craving and VAS-pain) and Depression, Anxiety and Stress Scale (DASS), respectively. VAS-craving and VAS-pain were also determined immediately after conversion. A total of 37 participants completed the protocol. The mean COMM decreased from 17.1 to 6.7 (F = 36.5; <i>p</i> < 0.000), the mean VAS-craving decreased from 39.3 to 5.3 (−86.6%; F = 26.5, <i>p</i> < 0.000), the mean DASS decreased from 12.1 to 6.6 (F = 56.3, <i>p</i> < 0.000), and the mean VAS-pain decreased from 51.3 to 37.2 (−27.4%, F = 3.3; <i>p</i> = 0.043). Rotation to BuNa in patients with CNCP and OUD was accompanied by reductions in (i) opioid misuse, (ii) opioid craving, (iii) the severity of co-occurring psychiatric symptoms, and (iv) self-reported pain. BuNa as opioid agonist treatment may therefore be a beneficial strategy in CNCP patients with OUD. The limited sample size and the observational nature of this study underline the need for the replication of the current findings in large-scale, controlled studies.https://www.mdpi.com/2077-0383/10/16/3727opioid use disorderchronic non-cancer painbuprenorphine/naloxoneopioid misusecravingdepression |
| spellingShingle | Arnt F. A. Schellekens Stijn E. Veldman Eka S. D. Suranto Steffie M. van Rijswijk Selina E. I. van der Wal Aart H. Schene Marleen H. C. T. van Beek Beneficial Effects of Opioid Rotation to Buprenorphine/Naloxone on Opioid Misuse, Craving, Mental Health, and Pain Control in Chronic Non-Cancer Pain Patients with Opioid Use Disorder Journal of Clinical Medicine opioid use disorder chronic non-cancer pain buprenorphine/naloxone opioid misuse craving depression |
| title | Beneficial Effects of Opioid Rotation to Buprenorphine/Naloxone on Opioid Misuse, Craving, Mental Health, and Pain Control in Chronic Non-Cancer Pain Patients with Opioid Use Disorder |
| title_full | Beneficial Effects of Opioid Rotation to Buprenorphine/Naloxone on Opioid Misuse, Craving, Mental Health, and Pain Control in Chronic Non-Cancer Pain Patients with Opioid Use Disorder |
| title_fullStr | Beneficial Effects of Opioid Rotation to Buprenorphine/Naloxone on Opioid Misuse, Craving, Mental Health, and Pain Control in Chronic Non-Cancer Pain Patients with Opioid Use Disorder |
| title_full_unstemmed | Beneficial Effects of Opioid Rotation to Buprenorphine/Naloxone on Opioid Misuse, Craving, Mental Health, and Pain Control in Chronic Non-Cancer Pain Patients with Opioid Use Disorder |
| title_short | Beneficial Effects of Opioid Rotation to Buprenorphine/Naloxone on Opioid Misuse, Craving, Mental Health, and Pain Control in Chronic Non-Cancer Pain Patients with Opioid Use Disorder |
| title_sort | beneficial effects of opioid rotation to buprenorphine naloxone on opioid misuse craving mental health and pain control in chronic non cancer pain patients with opioid use disorder |
| topic | opioid use disorder chronic non-cancer pain buprenorphine/naloxone opioid misuse craving depression |
| url | https://www.mdpi.com/2077-0383/10/16/3727 |
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