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Drug Alcohol Depend. 2016 Dec 1;169:68-72. doi: 10.1016/j.drugalcdep.2016.10.009. Epub 2016 Oct 17.

Delay discounting in opioid use disorder: Differences between heroin and prescription opioid users.

Author information

1
Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States. Electronic address: skarakula@harvard.mclean.edu.
2
Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States.
3
Department of Psychology, Rutgers University, 152 Frelinghuysen Rd., Piscataway, NJ 08854, United States.
4
Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States.

Abstract

BACKGROUND:

Among those with opioid use disorder, heroin use is associated with poorer prognosis relative to use of prescription opioids alone. However, relatively little is known about distinguishing features between those who use heroin relative to those who use prescription opioids. In the present study we evaluated differences in delay discounting in those with opioid use disorder based on primary opioid of use. Delay discounting is associated with a range of negative outcomes and is an important therapeutic target in this population.

METHODS:

Treatment-seeking adults with opioid dependence completed self-report measures including past-month opioid use and the Monetary Choice Questionnaire (Kirby and Marakovic, 1996; Kirby et al., 1999), a measure of delay discounting. Participants were divided into two groups based on whether they used any heroin in the past 30days or only prescription opioids, and delay discounting scores were compared between the groups. Group differences in sociodemographic or clinical variables were included in the analysis as covariates.

RESULTS:

Results from a forward stepwise linear regression indicated that heroin use was associated with significantly higher delay discounting (B=-0.99, SEB=0.34, t=-2.88, p=0.005), even when considering covariates.

CONCLUSIONS:

Adults with opioid dependence who exclusively used prescription opioids had lower delay discounting relative to those who used heroin. This finding contributes further to the literature suggesting that heroin use is associated with greater clinical severity among those with opioid use disorder.

KEYWORDS:

Addiction; Delay discounting; Heroin; Impulsivity; Opioid use disorder; Prescription opioids

PMID:
27776247
PMCID:
PMC5486990
DOI:
10.1016/j.drugalcdep.2016.10.009
[Indexed for MEDLINE]
Free PMC Article

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