@article{ref1,
title="Using behavioral economics to predict opioid use during prescription opioid dependence treatment",
journal="Drug and alcohol dependence",
year="2014",
author="Worley, Matthew J. and Shoptaw, Steven J. and Bickel, Warren K. and Ling, Walter",
volume="148",
number="",
pages="62-68",
abstract="BACKGROUND: Research grounded in behavioral economics has previously linked addictive behavior to disrupted decision-making and reward-processing, but these principles have not been examined in prescription opioid addiction, which is currently a major public health problem. This study examined whether pre-treatment drug reinforcement value predicted opioid use during outpatient treatment of prescription opioid addiction. <br><br>METHODS: Secondary analyses examined participants with prescription opioid dependence who received 12 weeks of buprenorphine-naloxone and counseling in a multi-site clinical trial (N=353). Baseline measures assessed opioid source and indices of drug reinforcement value, including the total amount and proportion of income spent on drugs. Weekly urine drug screens measured opioid use. <br><br>RESULTS: Obtaining opioids from doctors was associated with lower pre-treatment drug spending, while obtaining opioids from dealers/patients was associated with greater spending. Controlling for demographics, opioid use history, and opioid source frequency, patients who spent a greater total amount (OR=1.30, p<.001) and a greater proportion of their income on drugs (OR=1.31, p<.001) were more likely to use opioids during treatment. <br><br>CONCLUSIONS: Individual differences in drug reinforcement value, as indicated by pre-treatment allocation of economic resources to drugs, reflects propensity for continued opioid use during treatment among individuals with prescription opioid addiction. Future studies should examine disrupted decision-making and reward-processing in prescription opioid users more directly and test whether reinforcer pathology can be remediated in this population.<p /> <p>Language: en</p>",
language="en",
issn="0376-8716",
doi="10.1016/j.drugalcdep.2014.12.018",
url="http://dx.doi.org/10.1016/j.drugalcdep.2014.12.018"
}