Longitudinal Cohort Study of Opioid Use Disorder

About This Grant

Project Summary/Abstract Recovery from opioid use disorder occurs against a constantly and rapidly evolving backdrop of new treatments, changes in policy and public health initiatives, and emerging drug threats. These ongoing changes result in major knowledge gaps with respect to long-term treatment outcomes and recovery processes, which can cause treatment and public health efforts to fall behind. For example, major longitudinal studies of opioid use disorder occurred prior to the recent expansion of treatment options (e.g., availability of low-barrier buprenorphine; FDA approval of extended-release injectable buprenorphine) and the saturation of the drug supply with fentanyl and other potent synthetic opioids. The objective of the proposed study is to characterize the longitudinal course of opioid use disorder through the remote follow-up of a cohort of 550 adults with opioid use disorder recruited from sites across the United States. This study is innovative in its use of monthly, remote patient-reported outcomes as well as annual interviewer-administered outcomes, providing high-quality, temporally precise data that is a significant advancement over prior longitudinal studies that have relied on retrospective recall over long time frames (e.g., 1 year or more). In our prior work, participants completed more than 80% of all possible monthly assessments, supporting the feasibility of this approach. Furthermore, our study will consider not only substance use outcomes, but also domains of recovery that can provide novel insights into long-term treatment outcomes, recovery trajectories and factors influencing risk for poor functioning and sustained opioid use. Critically, this will allow for the consideration of improvements that may occur in the absence of full abstinence from opioids (i.e., non-abstinent outcomes). We will use highly rigorous and well-validated methods for longitudinal data analysis, including the management of missing data. Our study aims include: (1) Extend and expand a follow-up study of adults with opioid use disorder to characterize the long-term course of recovery, including changes in substance use and functioning; (2) Identify predictors of opioid use and recovery over time; and (3) Identify recovery profiles and candidates for non-abstinent outcomes. If successful, this project would provide answers to high-priority questions about opioid use disorder recovery and course in the current treatment and drug supply landscape, and (2) a rich, longitudinal dataset that can be used for analysis of newly emerging and time-sensitive questions about opioid use disorder to ultimate improve outcomes for people with opioid use disorder, their families and their communities.