TY - JOUR
KW - Affect/drug effects
KW - Buprenorphine/therapeutic use
KW - Cocaine-Related Disorders/psychology
KW - Craving/physiology
KW - Ecological momentary assessment
KW - Female
KW - Humans
KW - Male
KW - Methadone/therapeutic use
KW - Middle Aged
KW - Opiate Substitution Treatment/methods
KW - Opioid-Related Disorders/psychology
KW - Recurrence
KW - smartphone
KW - Stress, Psychological/psychology
KW - buprenorphine
KW - cocaine
KW - craving
KW - Methadone
KW - opioid use disorder
KW - stress
KW - Time-varying effects modeling (TVEM)
AU - L. V. Panlilio
AU - S. W. Stull
AU - J. W. Bertz
AU - A. J. Burgess-Hull
AU - S. T. Lanza
AU - B. L. Curtis
AU - K. A. Phillips
AU - D. H. Epstein
AU - K. L. Preston
A1 - 
AB - RATIONALE: Given that many patients being treated for opioid-use disorder continue to use drugs, identifying clusters of patients who share similar patterns of use might provide insight into the disorder, the processes that affect it, and ways that treatment can be personalized. OBJECTIVES AND METHODS: We applied hierarchical clustering to identify patterns of opioid and cocaine use in 309 participants being treated with methadone or buprenorphine (in a buprenorphine-naloxone formulation) for up to 16 weeks. A smartphone app was used to assess stress and craving at three random times per day over the course of the study. RESULTS: Five basic patterns of use were identified: frequent opioid use, frequent cocaine use, frequent dual use (opioids and cocaine), sporadic use, and infrequent use. These patterns were differentially associated with medication (methadone vs. buprenorphine), race, age, drug-use history, drug-related problems prior to the study, stress-coping strategies, specific triggers of use events, and levels of cue exposure, craving, and negative mood. Craving tended to increase before use in all except those who used sporadically. Craving was sharply higher during the 90 min following moderate-to-severe stress in those with frequent use, but only moderately higher in those with infrequent or sporadic use. CONCLUSIONS: People who share similar patterns of drug-use during treatment also tend to share similarities with respect to psychological processes that surround instances of use, such as stress-induced craving. Cluster analysis combined with smartphone-based experience sampling provides an effective strategy for studying how drug use is related to personal and environmental factors.
AD - Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA. lpanlili@intra.nida.nih.gov.; Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA.; Department of Biobehavioral Health, The Pennsylvania State University, State College, PA, USA.; Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA.; Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA.; Department of Biobehavioral Health, The Pennsylvania State University, State College, PA, USA.; Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA.; Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA.; Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA.; Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, USA.
BT - Psychopharmacology
C5 - Education & Workforce; Opioids & Substance Use
CP - 6
DO - 10.1007/s00213-021-05782-2
IS - 6
JF - Psychopharmacology
LA - eng
M1 - Journal Article
N2 - RATIONALE: Given that many patients being treated for opioid-use disorder continue to use drugs, identifying clusters of patients who share similar patterns of use might provide insight into the disorder, the processes that affect it, and ways that treatment can be personalized. OBJECTIVES AND METHODS: We applied hierarchical clustering to identify patterns of opioid and cocaine use in 309 participants being treated with methadone or buprenorphine (in a buprenorphine-naloxone formulation) for up to 16 weeks. A smartphone app was used to assess stress and craving at three random times per day over the course of the study. RESULTS: Five basic patterns of use were identified: frequent opioid use, frequent cocaine use, frequent dual use (opioids and cocaine), sporadic use, and infrequent use. These patterns were differentially associated with medication (methadone vs. buprenorphine), race, age, drug-use history, drug-related problems prior to the study, stress-coping strategies, specific triggers of use events, and levels of cue exposure, craving, and negative mood. Craving tended to increase before use in all except those who used sporadically. Craving was sharply higher during the 90 min following moderate-to-severe stress in those with frequent use, but only moderately higher in those with infrequent or sporadic use. CONCLUSIONS: People who share similar patterns of drug-use during treatment also tend to share similarities with respect to psychological processes that surround instances of use, such as stress-induced craving. Cluster analysis combined with smartphone-based experience sampling provides an effective strategy for studying how drug use is related to personal and environmental factors.
PY - 2021
SN - 1432-2072; 0033-3158; 0033-3158
SP - 1513
EP - 1529
EP - 
T1 - Beyond abstinence and relapse II: momentary relationships between stress, craving, and lapse within clusters of patients with similar patterns of drug use
T2 - Psychopharmacology
TI - Beyond abstinence and relapse II: momentary relationships between stress, craving, and lapse within clusters of patients with similar patterns of drug use
U1 - Education & Workforce; Opioids & Substance Use
U2 - 33558983
U3 - 10.1007/s00213-021-05782-2
VL - 238
VO - 1432-2072; 0033-3158; 0033-3158
Y1 - 2021
Y2 - Jun
ER -