People with opioid use disorders: A taxonomy of treatment entrants to support the development of a profile-based approach to care.

Journal: Drug and alcohol review

Volume: 42

Issue: 4

Year of Publication: 2023

Affiliated Institutions:  Douglas Research Centre, Montréal, Canada. Institut Universitaire sur les Dépendances, Montréal, Canada. Centre Hospitalier de l'Université de Montréal Research Center, Montréal, Canada. Département des Sciences de la Santé Communautaire, Université de Sherbrooke, Montréal, Canada. Department of Sociology, Gaston Berger University, Saint-Louis, Senegal.

Abstract summary 

People with opioid use disorders (OUD) present with high levels of medical and psychosocial vulnerabilities. In recent years, studies have highlighted a shift in demographic and biopsychosocial profiles of people with OUD. In order to support the development of a profile-based approach to care, this study aims to identify different profiles of people with OUD in a sample of patients admitted to a specialised opioid agonist treatment (OAT) facility.Twenty-three categorical variables (demographic, clinical, indicators of health and social precariousness) were retrieved from a sample of 296 patient charts in a large Montréal-based OAT facility (2017-2019). Descriptive analyses were followed by a three-step latent class analysis (LCA) to identify different socio-clinical profiles and examine their association with demographic variables.The LCA revealed three socio-clinical profiles: (i) "polysubstance use with psychiatric, physical and social vulnerabilities" (37% of the sample); (ii) "heroin use with vulnerabilities to anxiety and depression" (33%); (iii) "pharmaceutical-type opioid use with vulnerabilities to anxiety, depression and chronic pain" (30%). Class 3 individuals were more likely to be aged 45 years and older.While current approaches (such as low- and regular-threshold services) may be suited for many OUD treatment entrants, there may be a need to improve the continuum of care between mental health, chronic pain, and addiction services for those characterised by the use of pharmaceutical-type opioids, chronic pain and older age. Overall, the results support further exploring profile-based approaches to care, tailored to subgroups of patients with differing needs or abilities.

Authors & Co-authors:  Archambault Léonie L Bertrand Karine K Jutras-Aswad Didier D Monson Eva E Touré El Hadj EH Perreault Michel M

Study Outcome 

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Statistics
Citations :  Blanco C, Volkow ND. Management of opioid use disorder in the USA: present status and future directions. Lancet. 2019;393:1760-72.
Authors :  6
Identifiers
Doi : 10.1111/dar.13634
SSN : 1465-3362
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
health services needs;opioid use disorder;taxonomy
Study Design
Descriptive Study
Study Approach
Country of Study
Publication Country
Australia