Relationship between opioid cross-tolerance during buprenorphine stabilization and return to opioid use during buprenorphine dose tapering
Rationale Opioid injection drug use (IDU) has been linked to a more severe pattern of use (e.g. tolerance, overdose risk) and shorter retention in treatment, which may undermine abstinence attempts. Objectives This secondary data analysis of four human laboratory studies investigated whether current...
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| Veröffentlicht in: | Psychopharmacology 2024-06, Vol.241 (6), p.1151-1160 |
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| creator | Greenwald, Mark K. Sogbesan, Tolani Moses, Tabitha E.H. |
| description | Rationale
Opioid injection drug use (IDU) has been linked to a more severe pattern of use (e.g. tolerance, overdose risk) and shorter retention in treatment, which may undermine abstinence attempts.
Objectives
This secondary data analysis of four human laboratory studies investigated whether current opioid IDU modulates subjective abuse liability responses to high-dose hydromorphone during intermediate-dose buprenorphine stabilization (designed to suppress withdrawal but allow surmountable agonist effects), and whether hydromorphone response magnitude predicts latency of return to opioid use during buprenorphine dose-tapering.
Methods
Regular heroin users not currently seeking treatment (
n
= 54; 29 current injectors, 25 non-injectors) were stabilized on 8-mg/day sublingual buprenorphine and assessed for subjective responses (e.g. ‘liking’, craving) to hydromorphone 24-mg intramuscular challenge (administered 16-hr post-buprenorphine) under randomized, double-blinded, controlled conditions. A subgroup (
n
= 35) subsequently completed a standardized 3-week outpatient buprenorphine dose-taper, paired with opioid-abstinent contingent reinforcement, and were assessed for return to opioid use based on thrice-weekly urinalysis and self-report.
Results
During buprenorphine stabilization, IDU reported lower ‘liking’ of buprenorphine and post-hydromorphone peak ‘liking’, ‘good effect’ and ‘high’ compared to non-IDU. Less hydromorphone peak increase-from-baseline in ‘liking’ (which correlated with less hydromorphone-induced craving suppression) predicted significantly faster return to opioid use during buprenorphine dose-tapering.
Conclusions
In these buprenorphine-stabilized regular heroin users, IDU is associated with attenuated ‘liking’ response (more cross-tolerance) to buprenorphine and to high-dose hydromorphone challenge and, in turn, this cross-tolerance (but not IDU) predicts faster return to opioid use. Further research should examine mechanisms that link cross-tolerance to treatment response. |
| doi_str_mv | 10.1007/s00213-024-06549-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2923909222</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3056899612</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-a2b9123453fa438903667a90856f9c401d2ed3302de3175105645628a342771c3</originalsourceid><addsrcrecordid>eNp9kUFrFTEQx4Mo9ln9Ah4k4MVL7CSTzW6OUmorFISi55DdnWdT9iVrsovoR_BTm_deqyBoLjnMb36ZzJ-xlxLeSoD2rAAoiQKUFmAabYV8xDZSoxIKWvWYbQAQBcqmO2HPSrmDenSnn7IT7FCZBsyG_byhyS8hxXIbZt7T8o0o8jSHFEY-5FSKWNJE2ceB-LjmEL_wfp0zxZTn2xCJl8X3YQo_Dhbu48gzLWuOfEkPnrX8o3dMtbL4mfa15-zJ1k-FXtzfp-zz-4tP51fi-uPlh_N312KoQy_Cq95KhbrBrdfYWUBjWm-ha8zWDhrkqGhEBDUSyraR0BjdGNV51Kpt5YCn7M3RO-f0daWyuF0oA02Tj5TW4pRVaMEqpSr6-i_0LtWv1ekcVm9nrZF7Sh2pw74ybd2cw87n706C2yfljkm5mpQ7JOVkbXp1r177HY2_Wx6iqQAegTLvt0P5z9v_0f4CCOifww</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3056899612</pqid></control><display><type>article</type><title>Relationship between opioid cross-tolerance during buprenorphine stabilization and return to opioid use during buprenorphine dose tapering</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Greenwald, Mark K. ; Sogbesan, Tolani ; Moses, Tabitha E.H.</creator><creatorcontrib>Greenwald, Mark K. ; Sogbesan, Tolani ; Moses, Tabitha E.H.</creatorcontrib><description>Rationale
Opioid injection drug use (IDU) has been linked to a more severe pattern of use (e.g. tolerance, overdose risk) and shorter retention in treatment, which may undermine abstinence attempts.
Objectives
This secondary data analysis of four human laboratory studies investigated whether current opioid IDU modulates subjective abuse liability responses to high-dose hydromorphone during intermediate-dose buprenorphine stabilization (designed to suppress withdrawal but allow surmountable agonist effects), and whether hydromorphone response magnitude predicts latency of return to opioid use during buprenorphine dose-tapering.
Methods
Regular heroin users not currently seeking treatment (
n
= 54; 29 current injectors, 25 non-injectors) were stabilized on 8-mg/day sublingual buprenorphine and assessed for subjective responses (e.g. ‘liking’, craving) to hydromorphone 24-mg intramuscular challenge (administered 16-hr post-buprenorphine) under randomized, double-blinded, controlled conditions. A subgroup (
n
= 35) subsequently completed a standardized 3-week outpatient buprenorphine dose-taper, paired with opioid-abstinent contingent reinforcement, and were assessed for return to opioid use based on thrice-weekly urinalysis and self-report.
Results
During buprenorphine stabilization, IDU reported lower ‘liking’ of buprenorphine and post-hydromorphone peak ‘liking’, ‘good effect’ and ‘high’ compared to non-IDU. Less hydromorphone peak increase-from-baseline in ‘liking’ (which correlated with less hydromorphone-induced craving suppression) predicted significantly faster return to opioid use during buprenorphine dose-tapering.
Conclusions
In these buprenorphine-stabilized regular heroin users, IDU is associated with attenuated ‘liking’ response (more cross-tolerance) to buprenorphine and to high-dose hydromorphone challenge and, in turn, this cross-tolerance (but not IDU) predicts faster return to opioid use. Further research should examine mechanisms that link cross-tolerance to treatment response.</description><identifier>ISSN: 0033-3158</identifier><identifier>ISSN: 1432-2072</identifier><identifier>EISSN: 1432-2072</identifier><identifier>DOI: 10.1007/s00213-024-06549-1</identifier><identifier>PMID: 38326506</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Analgesics, Opioid - administration & dosage ; Biomedical and Life Sciences ; Biomedicine ; Buprenorphine ; Buprenorphine - administration & dosage ; Controlled conditions ; Cross-tolerance ; Dose-Response Relationship, Drug ; Double-Blind Method ; Drug abuse ; Drug Tapering - methods ; Drug Tolerance ; Female ; Heroin ; Heroin Dependence - drug therapy ; Humans ; Hydromorphone - administration & dosage ; Latency ; Male ; Middle Aged ; Narcotic Antagonists - administration & dosage ; Narcotics ; Neurosciences ; Opiate Substitution Treatment - methods ; Opioid-Related Disorders - drug therapy ; Opioids ; Original Investigation ; Pharmacology/Toxicology ; Psychiatry ; Substance Withdrawal Syndrome - drug therapy ; Urinalysis ; Young Adult</subject><ispartof>Psychopharmacology, 2024-06, Vol.241 (6), p.1151-1160</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-a2b9123453fa438903667a90856f9c401d2ed3302de3175105645628a342771c3</cites><orcidid>0000-0002-9541-7321</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00213-024-06549-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00213-024-06549-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38326506$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Greenwald, Mark K.</creatorcontrib><creatorcontrib>Sogbesan, Tolani</creatorcontrib><creatorcontrib>Moses, Tabitha E.H.</creatorcontrib><title>Relationship between opioid cross-tolerance during buprenorphine stabilization and return to opioid use during buprenorphine dose tapering</title><title>Psychopharmacology</title><addtitle>Psychopharmacology</addtitle><addtitle>Psychopharmacology (Berl)</addtitle><description>Rationale
Opioid injection drug use (IDU) has been linked to a more severe pattern of use (e.g. tolerance, overdose risk) and shorter retention in treatment, which may undermine abstinence attempts.
Objectives
This secondary data analysis of four human laboratory studies investigated whether current opioid IDU modulates subjective abuse liability responses to high-dose hydromorphone during intermediate-dose buprenorphine stabilization (designed to suppress withdrawal but allow surmountable agonist effects), and whether hydromorphone response magnitude predicts latency of return to opioid use during buprenorphine dose-tapering.
Methods
Regular heroin users not currently seeking treatment (
n
= 54; 29 current injectors, 25 non-injectors) were stabilized on 8-mg/day sublingual buprenorphine and assessed for subjective responses (e.g. ‘liking’, craving) to hydromorphone 24-mg intramuscular challenge (administered 16-hr post-buprenorphine) under randomized, double-blinded, controlled conditions. A subgroup (
n
= 35) subsequently completed a standardized 3-week outpatient buprenorphine dose-taper, paired with opioid-abstinent contingent reinforcement, and were assessed for return to opioid use based on thrice-weekly urinalysis and self-report.
Results
During buprenorphine stabilization, IDU reported lower ‘liking’ of buprenorphine and post-hydromorphone peak ‘liking’, ‘good effect’ and ‘high’ compared to non-IDU. Less hydromorphone peak increase-from-baseline in ‘liking’ (which correlated with less hydromorphone-induced craving suppression) predicted significantly faster return to opioid use during buprenorphine dose-tapering.
Conclusions
In these buprenorphine-stabilized regular heroin users, IDU is associated with attenuated ‘liking’ response (more cross-tolerance) to buprenorphine and to high-dose hydromorphone challenge and, in turn, this cross-tolerance (but not IDU) predicts faster return to opioid use. Further research should examine mechanisms that link cross-tolerance to treatment response.</description><subject>Adult</subject><subject>Analgesics, Opioid - administration & dosage</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Buprenorphine</subject><subject>Buprenorphine - administration & dosage</subject><subject>Controlled conditions</subject><subject>Cross-tolerance</subject><subject>Dose-Response Relationship, Drug</subject><subject>Double-Blind Method</subject><subject>Drug abuse</subject><subject>Drug Tapering - methods</subject><subject>Drug Tolerance</subject><subject>Female</subject><subject>Heroin</subject><subject>Heroin Dependence - drug therapy</subject><subject>Humans</subject><subject>Hydromorphone - administration & dosage</subject><subject>Latency</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Narcotic Antagonists - administration & dosage</subject><subject>Narcotics</subject><subject>Neurosciences</subject><subject>Opiate Substitution Treatment - methods</subject><subject>Opioid-Related Disorders - drug therapy</subject><subject>Opioids</subject><subject>Original Investigation</subject><subject>Pharmacology/Toxicology</subject><subject>Psychiatry</subject><subject>Substance Withdrawal Syndrome - drug therapy</subject><subject>Urinalysis</subject><subject>Young Adult</subject><issn>0033-3158</issn><issn>1432-2072</issn><issn>1432-2072</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUFrFTEQx4Mo9ln9Ah4k4MVL7CSTzW6OUmorFISi55DdnWdT9iVrsovoR_BTm_deqyBoLjnMb36ZzJ-xlxLeSoD2rAAoiQKUFmAabYV8xDZSoxIKWvWYbQAQBcqmO2HPSrmDenSnn7IT7FCZBsyG_byhyS8hxXIbZt7T8o0o8jSHFEY-5FSKWNJE2ceB-LjmEL_wfp0zxZTn2xCJl8X3YQo_Dhbu48gzLWuOfEkPnrX8o3dMtbL4mfa15-zJ1k-FXtzfp-zz-4tP51fi-uPlh_N312KoQy_Cq95KhbrBrdfYWUBjWm-ha8zWDhrkqGhEBDUSyraR0BjdGNV51Kpt5YCn7M3RO-f0daWyuF0oA02Tj5TW4pRVaMEqpSr6-i_0LtWv1ekcVm9nrZF7Sh2pw74ybd2cw87n706C2yfljkm5mpQ7JOVkbXp1r177HY2_Wx6iqQAegTLvt0P5z9v_0f4CCOifww</recordid><startdate>20240601</startdate><enddate>20240601</enddate><creator>Greenwald, Mark K.</creator><creator>Sogbesan, Tolani</creator><creator>Moses, Tabitha E.H.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QG</scope><scope>7QR</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9541-7321</orcidid></search><sort><creationdate>20240601</creationdate><title>Relationship between opioid cross-tolerance during buprenorphine stabilization and return to opioid use during buprenorphine dose tapering</title><author>Greenwald, Mark K. ; Sogbesan, Tolani ; Moses, Tabitha E.H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-a2b9123453fa438903667a90856f9c401d2ed3302de3175105645628a342771c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Analgesics, Opioid - administration & dosage</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Buprenorphine</topic><topic>Buprenorphine - administration & dosage</topic><topic>Controlled conditions</topic><topic>Cross-tolerance</topic><topic>Dose-Response Relationship, Drug</topic><topic>Double-Blind Method</topic><topic>Drug abuse</topic><topic>Drug Tapering - methods</topic><topic>Drug Tolerance</topic><topic>Female</topic><topic>Heroin</topic><topic>Heroin Dependence - drug therapy</topic><topic>Humans</topic><topic>Hydromorphone - administration & dosage</topic><topic>Latency</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Narcotic Antagonists - administration & dosage</topic><topic>Narcotics</topic><topic>Neurosciences</topic><topic>Opiate Substitution Treatment - methods</topic><topic>Opioid-Related Disorders - drug therapy</topic><topic>Opioids</topic><topic>Original Investigation</topic><topic>Pharmacology/Toxicology</topic><topic>Psychiatry</topic><topic>Substance Withdrawal Syndrome - drug therapy</topic><topic>Urinalysis</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Greenwald, Mark K.</creatorcontrib><creatorcontrib>Sogbesan, Tolani</creatorcontrib><creatorcontrib>Moses, Tabitha E.H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Animal Behavior Abstracts</collection><collection>Chemoreception Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Psychopharmacology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Greenwald, Mark K.</au><au>Sogbesan, Tolani</au><au>Moses, Tabitha E.H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relationship between opioid cross-tolerance during buprenorphine stabilization and return to opioid use during buprenorphine dose tapering</atitle><jtitle>Psychopharmacology</jtitle><stitle>Psychopharmacology</stitle><addtitle>Psychopharmacology (Berl)</addtitle><date>2024-06-01</date><risdate>2024</risdate><volume>241</volume><issue>6</issue><spage>1151</spage><epage>1160</epage><pages>1151-1160</pages><issn>0033-3158</issn><issn>1432-2072</issn><eissn>1432-2072</eissn><abstract>Rationale
Opioid injection drug use (IDU) has been linked to a more severe pattern of use (e.g. tolerance, overdose risk) and shorter retention in treatment, which may undermine abstinence attempts.
Objectives
This secondary data analysis of four human laboratory studies investigated whether current opioid IDU modulates subjective abuse liability responses to high-dose hydromorphone during intermediate-dose buprenorphine stabilization (designed to suppress withdrawal but allow surmountable agonist effects), and whether hydromorphone response magnitude predicts latency of return to opioid use during buprenorphine dose-tapering.
Methods
Regular heroin users not currently seeking treatment (
n
= 54; 29 current injectors, 25 non-injectors) were stabilized on 8-mg/day sublingual buprenorphine and assessed for subjective responses (e.g. ‘liking’, craving) to hydromorphone 24-mg intramuscular challenge (administered 16-hr post-buprenorphine) under randomized, double-blinded, controlled conditions. A subgroup (
n
= 35) subsequently completed a standardized 3-week outpatient buprenorphine dose-taper, paired with opioid-abstinent contingent reinforcement, and were assessed for return to opioid use based on thrice-weekly urinalysis and self-report.
Results
During buprenorphine stabilization, IDU reported lower ‘liking’ of buprenorphine and post-hydromorphone peak ‘liking’, ‘good effect’ and ‘high’ compared to non-IDU. Less hydromorphone peak increase-from-baseline in ‘liking’ (which correlated with less hydromorphone-induced craving suppression) predicted significantly faster return to opioid use during buprenorphine dose-tapering.
Conclusions
In these buprenorphine-stabilized regular heroin users, IDU is associated with attenuated ‘liking’ response (more cross-tolerance) to buprenorphine and to high-dose hydromorphone challenge and, in turn, this cross-tolerance (but not IDU) predicts faster return to opioid use. Further research should examine mechanisms that link cross-tolerance to treatment response.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>38326506</pmid><doi>10.1007/s00213-024-06549-1</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-9541-7321</orcidid></addata></record> |
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| ispartof | Psychopharmacology, 2024-06, Vol.241 (6), p.1151-1160 |
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| subjects | Adult Analgesics, Opioid - administration & dosage Biomedical and Life Sciences Biomedicine Buprenorphine Buprenorphine - administration & dosage Controlled conditions Cross-tolerance Dose-Response Relationship, Drug Double-Blind Method Drug abuse Drug Tapering - methods Drug Tolerance Female Heroin Heroin Dependence - drug therapy Humans Hydromorphone - administration & dosage Latency Male Middle Aged Narcotic Antagonists - administration & dosage Narcotics Neurosciences Opiate Substitution Treatment - methods Opioid-Related Disorders - drug therapy Opioids Original Investigation Pharmacology/Toxicology Psychiatry Substance Withdrawal Syndrome - drug therapy Urinalysis Young Adult |
| title | Relationship between opioid cross-tolerance during buprenorphine stabilization and return to opioid use during buprenorphine dose tapering |
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