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Intermittent Marijuana Use Is Associated with Improved Retention in Naltrexone Treatment for Opiate-Dependence.

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Title: Intermittent Marijuana Use Is Associated with Improved Retention in Naltrexone Treatment for Opiate-Dependence.
Authors: Raby, Wilfrid Noel (AUTHOR), Carpenter, Kenneth M. (AUTHOR), Rothenberg, Jami (AUTHOR), Brooks, Adam C. (AUTHOR), Jiang, Huiping (AUTHOR), Sullivan, Maria (AUTHOR), Bisaga, Adam (AUTHOR), Comer, Sandra (AUTHOR), Nunes, Edward V. (AUTHOR)
Source: American Journal on Addictions. Jul2009, Vol. 18 Issue 4, p301-308. 8p. 3 Charts, 2 Graphs.
Subjects: Marijuana, Naltrexone, Drugs of abuse, Drug addiction, Cannabis (Genus), Detoxification (Alternative medicine), Toxicology, Cannabinoids, Drug use testing
Abstract: Naltrexone is a theoretically promising alternative to agonist substitution treatment for opioid dependence, but its effectiveness has been severely limited by poor adherence. This study examined, in an independent sample, a previously observed association between moderate cannabis use and improved retention in naltrexone treatment. Opioid dependent patients (N = 63), admitted for inpatient detoxification and induction onto oral naltrexone, and randomized into a six-month trial of intensive behavioral therapy (Behavioral Naltrexone Therapy) versus a control behavioral therapy (Compliance Enhancement), were classified into three levels of cannabis use during treatment based on biweekly urine toxicology: abstinent (0% cannabis positive urine samples); intermittent use (1% to 79% cannabis positive samples); and consistent use (80% or greater cannabis positive samples). Intermittent cannabis users showed superior retention in naltrexone treatment (median days retained = 133; mean = 112.8, SE = 17.5), compared to abstinent (median = 35; mean = 47.3, SE = 9.2) or consistent users (median = 35; mean = 68.3, SE = 14.1) (log rank = 12.2, df = 2, p = .002). The effect remained significant in a Cox model after adjustment for baseline level of heroin use and during treatment level of cocaine use. Intermittent cannabis use was also associated with greater adherence to naltrexone pill-taking. Treatment interacted with cannabis use level, such that intensive behavioral therapy appeared to moderate the adverse prognosis in the consistent cannabis use group. The association between moderate cannabis use and improved retention on naltrexone treatment was replicated. Experimental studies are needed to directly test the hypothesis that cannabinoid agonists exert a beneficial pharmacological effect on naltrexone maintenance and to understand the mechanism. [ABSTRACT FROM AUTHOR]
Copyright of American Journal on Addictions is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Intermittent Marijuana Use Is Associated with Improved Retention in Naltrexone Treatment for Opiate-Dependence.
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  Data: <searchLink fieldCode="AR" term="%22Raby%2C+Wilfrid+Noel%22">Raby, Wilfrid Noel</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Carpenter%2C+Kenneth+M%2E%22">Carpenter, Kenneth M.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rothenberg%2C+Jami%22">Rothenberg, Jami</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Brooks%2C+Adam+C%2E%22">Brooks, Adam C.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Jiang%2C+Huiping%22">Jiang, Huiping</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Sullivan%2C+Maria%22">Sullivan, Maria</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bisaga%2C+Adam%22">Bisaga, Adam</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Comer%2C+Sandra%22">Comer, Sandra</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Nunes%2C+Edward+V%2E%22">Nunes, Edward V.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22American+Journal+on+Addictions%22">American Journal on Addictions</searchLink>. Jul2009, Vol. 18 Issue 4, p301-308. 8p. 3 Charts, 2 Graphs.
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  Data: <searchLink fieldCode="DE" term="%22Marijuana%22">Marijuana</searchLink><br /><searchLink fieldCode="DE" term="%22Naltrexone%22">Naltrexone</searchLink><br /><searchLink fieldCode="DE" term="%22Drugs+of+abuse%22">Drugs of abuse</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+addiction%22">Drug addiction</searchLink><br /><searchLink fieldCode="DE" term="%22Cannabis+%28Genus%29%22">Cannabis (Genus)</searchLink><br /><searchLink fieldCode="DE" term="%22Detoxification+%28Alternative+medicine%29%22">Detoxification (Alternative medicine)</searchLink><br /><searchLink fieldCode="DE" term="%22Toxicology%22">Toxicology</searchLink><br /><searchLink fieldCode="DE" term="%22Cannabinoids%22">Cannabinoids</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+use+testing%22">Drug use testing</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: Naltrexone is a theoretically promising alternative to agonist substitution treatment for opioid dependence, but its effectiveness has been severely limited by poor adherence. This study examined, in an independent sample, a previously observed association between moderate cannabis use and improved retention in naltrexone treatment. Opioid dependent patients (N = 63), admitted for inpatient detoxification and induction onto oral naltrexone, and randomized into a six-month trial of intensive behavioral therapy (Behavioral Naltrexone Therapy) versus a control behavioral therapy (Compliance Enhancement), were classified into three levels of cannabis use during treatment based on biweekly urine toxicology: abstinent (0% cannabis positive urine samples); intermittent use (1% to 79% cannabis positive samples); and consistent use (80% or greater cannabis positive samples). Intermittent cannabis users showed superior retention in naltrexone treatment (median days retained = 133; mean = 112.8, SE = 17.5), compared to abstinent (median = 35; mean = 47.3, SE = 9.2) or consistent users (median = 35; mean = 68.3, SE = 14.1) (log rank = 12.2, df = 2, p = .002). The effect remained significant in a Cox model after adjustment for baseline level of heroin use and during treatment level of cocaine use. Intermittent cannabis use was also associated with greater adherence to naltrexone pill-taking. Treatment interacted with cannabis use level, such that intensive behavioral therapy appeared to moderate the adverse prognosis in the consistent cannabis use group. The association between moderate cannabis use and improved retention on naltrexone treatment was replicated. Experimental studies are needed to directly test the hypothesis that cannabinoid agonists exert a beneficial pharmacological effect on naltrexone maintenance and to understand the mechanism. [ABSTRACT FROM AUTHOR]
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  Label:
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  Data: <i>Copyright of American Journal on Addictions is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1080/10550490902927785
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        Text: English
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        PageCount: 8
        StartPage: 301
    Subjects:
      – SubjectFull: Marijuana
        Type: general
      – SubjectFull: Naltrexone
        Type: general
      – SubjectFull: Drugs of abuse
        Type: general
      – SubjectFull: Drug addiction
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      – SubjectFull: Cannabis (Genus)
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      – SubjectFull: Toxicology
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      – SubjectFull: Cannabinoids
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      – SubjectFull: Drug use testing
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      – TitleFull: Intermittent Marijuana Use Is Associated with Improved Retention in Naltrexone Treatment for Opiate-Dependence.
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              Text: Jul2009
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