Opioid Use Disorder - Phase I
Synthesis
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Qualitative
Quantitative
Critical Appraisal
PRISMA
Abstract
Kevin Kallmes, Nicole Hardy, Karl Holub, Jeff Johnson, Kathryn CowieLast Edited: 2022-09-09

Here, we systematically review studies of pharmacological interventions for Opioid Use Disorder. We found 50 studies reporting over 4,500 patients, with methadone, buprenorphine, and naltrexone as the most common interventions. While our review had high heterogeneity in data elements reported, context of collection (which ranged from outpatient to imprisoned populations), several findings stood out from our data. First, retention rates in these studies are extremely low--averaging just over 50% (with the highest retention rate being for supervised heroin injections, with 85%). Regardless, improvement over placebo was noted; the average placebo recipient used opioids for 22.8 out of 30 days during therapy, compared to <12 days for all pharmacological therapies. Similarly, negative urine samples were noted in just 18% of the placebo population compared to 71.3% for naltrexone, 40.1% for buprenorphine, and 79.4% for methadone. The most common side effects were headache (12%), injection site reaction (11%), and nausea (9%).

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