Yi-Chien Ku
Y.-C. Ku1, T. S.-H. Lee2, L. Ma3, D. S. Metzger4. 1Crime Prevention Research Center, Academy for the Judiciary, Ministry of Justice, Taiwan; 2CTBC Center for Addiction Prevention and Policy Research, National Taiwan Normal University, Taiwan; 3National Center for AIDS Prevention and Control, China; 4HIV Prevention Research Division, University of Pennsylvania, United States
Background: Polydrug usage has garnered considerable attention due to its negative effects on treatment outcomes. To understand the factors associated with a successful reduction in opioid use in HPTN058, we examined demographics, polydrug use, and participation in counseling as potential predictors of medication-assisted treatment (MAT) outcomes.
Method: People who inject drugs (PWID) were enrolled at sites in China and Thailand. This study included participants who were randomized to 3 times per week dosing with buprenorphine/naloxone and 12 months of counseling (LT-MAT). Assessments for non-injection (NIP) and injection polydrug (IP) use for the past month. Assessments took place at baseline, 6-, 12-, 18-, and 24 months post-enrollment.
Results: We analyzed data from 623 participants assigned to the long-term treatment arm. Participants were mostly males (92.1%) and had an average age of 34.41 (SD=8.05), 3.6%-22.9% reported NIP, 0.5-3.8% reported IP during follow-up periods. The average number of counseling sessions was 16.4 of a possible 21 sessions. Overall, there was a significant decrease in opiate use over the study period. After we controlled for age, gender, follow-up periods, and non-injection drug use, the results from the negative binomial regression model found that the relationship between participation in counseling and opiate use was negatively moderated by IP.
Conclusion: The findings showed that Polydrug use undermines the effects of MAT and counseling in reducing opiate use. Future evaluation for MAT for OUD should take Polydrug usage into consideration.