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Using ecological momentary assessment to examine the relationship between craving and affect with opioid use in a clinical trial of clonidine as an adjunct medication to buprenorphine treatment

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  • Source:
    American journal of drug and alcohol abuse 2018 44 5, 502 (502-511)
  • Additional Information
    • Author(s):
      Kowalczyk WJ, Moran LM, Bertz JW, Phillips KA, Ghitza UE, Vahabzadeh M, Lin JL, Epstein DH, Preston KL
    • Language:
      English
    • Publication Type:
      Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Intramural
    • Record Status:
      This record is this issue.
    • Abstract:
      BACKGROUND: In a recent clinical trial (NCT00295308), we demonstrated that clonidine decreased the association between opioid craving and moderate levels of stress and affect in patients receiving buprenorphine-based opioid agonist therapy.OBJECTIVES: To examine the relationship between illicit opioid use and craving and affect during the evaluation of clonidine as an adjunct medication in buprenorphine treatment for opioid use disorder. Secondarily, to examine whether those relationships are driven by within- or between-participant factors.METHODS: This was a secondary data analysis from our original trial. Participants (N = 108, female: n = 23, male n = 85) receiving buprenorphine were randomized to receive adjunct clonidine or placebo. Participants used portable electronic devices to rate stress, mood, and craving via ecological momentary assessment (EMA) four times randomly each day. To associate the EMA data with illicit opioid use, each EMA report was linked to participants' next urine drug screen (thrice weekly). We used generalized linear mixed models to examine the interaction between treatment group and illicit opioid use, as well as to decompose the analysis into within- and between-participant effects.RESULTS: Craving for opioids and cocaine was increased when participants were using illicit opioids; this effect was greater in the clonidine group. For affect, mood was poorer during periods preceding opioid-positive urines than opioid-negative urines for clonidine-treated participants, whereas there was no difference for placebo participants.CONCLUSION: This secondary analysis provides evidence that for participants maintained on opioid agonist therapy, clonidine minimized the behavioral impact of moderate levels of negative affect and craving.
    • Medical Subject Headings (MeSH):
      Adult
      Female
      Humans
      Male
      Middle Aged
      Adrenergic alpha-2 Receptor Agonists/administration & dosage
      Affect/drug effects
      Craving/drug effects
      Double-Blind Method
      Drug Therapy, Combination
      Ecological Momentary Assessment
      Linear Models
      Narcotic Antagonists/administration & dosage
      Opiate Substitution Treatment/methods
      Opioid-Related Disorders/psychology
      Buprenorphine/*administration & dosage
      Clonidine/*administration & dosage
      Opioid-Related Disorders/*drug therapy
    • Source:
      This document should be cited as: Kowalczyk WJ Moran LM Bertz JW Phillips KA Ghitza UE Vahabzadeh M Lin JL Epstein DH Preston KL. Using ecological momentary assessment to examine the relationship between craving and affect with opioid use in a clinical trial of clonidine as an adjunct medication to buprenorphine treatment 2018 (The Cochrane Controlled Trials Register (CCTR/CENTRAL). DOI: 10.1080/00952990.2018.1454933. Oxford: Update Software. Updated quarterly.
    • Accession Number:
      CN-02000663
  • Citations
    • ABNT:
      KOWALCZYK WJ et al. Using ecological momentary assessment to examine the relationship between craving and affect with opioid use in a clinical trial of clonidine as an adjunct medication to buprenorphine treatment. American journal of drug and alcohol abuse, [s. l.], v. 44, n. 5, p. 502–511, 2018. DOI 10.1080/00952990.2018.1454933. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=cgh&AN=CN-02000663. Acesso em: 21 set. 2020.
    • AMA:
      Kowalczyk WJ, Moran LM, Bertz JW, et al. Using ecological momentary assessment to examine the relationship between craving and affect with opioid use in a clinical trial of clonidine as an adjunct medication to buprenorphine treatment. American journal of drug and alcohol abuse. 2018;44(5):502-511. doi:10.1080/00952990.2018.1454933
    • APA:
      Kowalczyk WJ, Moran LM, Bertz JW, Phillips KA, Ghitza UE, Vahabzadeh M, Lin JL, Epstein DH, & Preston KL. (2018). Using ecological momentary assessment to examine the relationship between craving and affect with opioid use in a clinical trial of clonidine as an adjunct medication to buprenorphine treatment. American Journal of Drug and Alcohol Abuse, 44(5), 502–511. https://doi.org/10.1080/00952990.2018.1454933
    • Chicago/Turabian: Author-Date:
      Kowalczyk WJ, Moran LM, Bertz JW, Phillips KA, Ghitza UE, Vahabzadeh M, Lin JL, Epstein DH, and Preston KL. 2018. “Using Ecological Momentary Assessment to Examine the Relationship between Craving and Affect with Opioid Use in a Clinical Trial of Clonidine as an Adjunct Medication to Buprenorphine Treatment.” American Journal of Drug and Alcohol Abuse 44 (5): 502–11. doi:10.1080/00952990.2018.1454933.
    • Harvard:
      Kowalczyk WJ et al. (2018) ‘Using ecological momentary assessment to examine the relationship between craving and affect with opioid use in a clinical trial of clonidine as an adjunct medication to buprenorphine treatment’, American journal of drug and alcohol abuse, 44(5), pp. 502–511. doi: 10.1080/00952990.2018.1454933.
    • Harvard: Australian:
      Kowalczyk WJ, Moran LM, Bertz JW, Phillips KA, Ghitza UE, Vahabzadeh M, Lin JL, Epstein DH & Preston KL 2018, ‘Using ecological momentary assessment to examine the relationship between craving and affect with opioid use in a clinical trial of clonidine as an adjunct medication to buprenorphine treatment’, American journal of drug and alcohol abuse, vol. 44, no. 5, pp. 502–511, viewed 21 September 2020, .
    • MLA:
      Kowalczyk WJ, et al. “Using Ecological Momentary Assessment to Examine the Relationship between Craving and Affect with Opioid Use in a Clinical Trial of Clonidine as an Adjunct Medication to Buprenorphine Treatment.” American Journal of Drug and Alcohol Abuse, vol. 44, no. 5, Jan. 2018, pp. 502–511. EBSCOhost, doi:10.1080/00952990.2018.1454933.
    • Chicago/Turabian: Humanities:
      Kowalczyk WJ, Moran LM, Bertz JW, Phillips KA, Ghitza UE, Vahabzadeh M, Lin JL, Epstein DH, and Preston KL. “Using Ecological Momentary Assessment to Examine the Relationship between Craving and Affect with Opioid Use in a Clinical Trial of Clonidine as an Adjunct Medication to Buprenorphine Treatment.” American Journal of Drug and Alcohol Abuse 44, no. 5 (January 1, 2018): 502–11. doi:10.1080/00952990.2018.1454933.
    • Vancouver/ICMJE:
      Kowalczyk WJ, Moran LM, Bertz JW, Phillips KA, Ghitza UE, Vahabzadeh M, et al. Using ecological momentary assessment to examine the relationship between craving and affect with opioid use in a clinical trial of clonidine as an adjunct medication to buprenorphine treatment. American journal of drug and alcohol abuse [Internet]. 2018 Jan 1 [cited 2020 Sep 21];44(5):502–11. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=cgh&AN=CN-02000663