Concurrent substance use and outcome in combined behavioral and naltrexone therapy for opiate dependence

Sarah H. Church, J. L. Rothenberg, M. A. Sullivan, G. Bornstein, E. V. Nunes

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

The effect of concurrent nonopiate drug use on outcome of treatment for opiate dependence. Method: Forty-seven opiate-dependent patients received a 6-month course of outpatient treatment with naltrexone and cognitive-behavioral therapy (behavioral naltrexone therapy, BNT) at a university-based research clinic. Opiate-negative urines and naltrexone ingestion were rewarded with monetary vouchers. Abstinence from other drugs was encouraged verbally, but no contingencies were placed on nonopiate drug use. The proportions of all urines (collected twice weekly) positive for cocaine, cannabis, and benzodiazepines over the course of treatment were evaluated as predictors of outcome of opiate dependence treatment, as measured by proportion of opiate-positive urines, days retained in treatment, and proportion of naltrexone doses taken, using Pearson product moment correlations and one-way analysis of variance (ANOVA). Results: The majority of patients (78%) used a nonopiate drug at least once during the trial. There were no significant correlations between concurrent drug use measures and opiate dependence treatment outcomes, indicating no simple linear relationship between these measures. However, when concurrent drug use was trichotomized into abstinent, intermittent, and heavy use groups, groups with intermittent use had superior outcome compared to both abstinent and heavy use groups in several contrasts. Conclusions: Intermittent use of non-opiate drugs is common during outpatient treatment for opiate dependence and may be a favorable prognostic indicator. This may support a "harm reduction" approach as opposed to a strict abstinence-oriented approach. Further research is needed to identify the optimal therapeutic stance toward other drug use during treatment for opiate dependence.

Original languageEnglish (US)
Pages (from-to)441-452
Number of pages12
JournalAmerican Journal of Drug and Alcohol Abuse
Volume27
Issue number3
DOIs
StatePublished - 2001
Externally publishedYes

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Opioid-Related Disorders
Naltrexone
Opiate Alkaloids
Pharmaceutical Preparations
Urine
Therapeutics
Outpatients
Harm Reduction
Cognitive Therapy
Cannabis
Benzodiazepines
Cocaine
Research
Analysis of Variance
Eating

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Pharmacology, Toxicology and Pharmaceutics(all)
  • Clinical Psychology

Cite this

Concurrent substance use and outcome in combined behavioral and naltrexone therapy for opiate dependence. / Church, Sarah H.; Rothenberg, J. L.; Sullivan, M. A.; Bornstein, G.; Nunes, E. V.

In: American Journal of Drug and Alcohol Abuse, Vol. 27, No. 3, 2001, p. 441-452.

Research output: Contribution to journalArticle

Church, Sarah H. ; Rothenberg, J. L. ; Sullivan, M. A. ; Bornstein, G. ; Nunes, E. V. / Concurrent substance use and outcome in combined behavioral and naltrexone therapy for opiate dependence. In: American Journal of Drug and Alcohol Abuse. 2001 ; Vol. 27, No. 3. pp. 441-452.
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