• Roger D Weiss, Jennifer Sharpe Potter, Margaret L Griffin, Scott E Provost, Garrett M Fitzmaurice, Katherine A McDermott, Emily N Srisarajivakul, Dorian R Dodd, Jessica A Dreifuss, R Kathryn McHugh, and Kathleen M Carroll.
• McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA. Electronic address: rweiss@mclean.harvard.edu.
• Drug Alcohol Depend. 2015 May 1; 150: 112-9.

BackgroundDespite the growing prevalence of prescription opioid dependence, longitudinal studies have not examined long-term treatment response. The current study examined outcomes over 42 months in the Prescription Opioid Addiction Treatment Study (POATS).MethodsPOATS was a multi-site clinical trial lasting up to 9 months, examining different durations of buprenorphine-naloxone plus standard medical management for prescription opioid dependence, with participants randomized to receive or not receive additional opioid drug counseling. A subset of participants (N=375 of 653) enrolled in a follow-up study. Telephone interviews were administered approximately 18, 30, and 42 months after main-trial enrollment. Comparison of baseline characteristics by follow-up participation suggested few differences.ResultsAt Month 42, much improvement was seen: 31.7% were abstinent from opioids and not on agonist therapy; 29.4% were receiving opioid agonist therapy, but met no symptom criteria for current opioid dependence; 7.5% were using illicit opioids while on agonist therapy; and the remaining 31.4% were using opioids without agonist therapy. Participants reporting a lifetime history of heroin use at baseline were more likely to meet DSM-IV criteria for opioid dependence at Month 42 (OR=4.56, 95% CI=1.29-16.04, p<.05). Engagement in agonist therapy was associated with a greater likelihood of illicit-opioid abstinence. Eight percent (n=27/338) used heroin for the first time during follow-up; 10.1% reported first-time injection heroin use.ConclusionsLong-term outcomes for those dependent on prescription opioids demonstrated clear improvement from baseline. However, a subset exhibited a worsening course, by initiating heroin use and/or injection opioid use.Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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