Author:
Elman Igor,Howard Margaret,Borodovsky Jacob T.,Mysels David,Rott David,Borsook David,Albanese Mark
Abstract
AbstractMetabolic hormones stabilize brain reward and motivational circuits, whereas excessive opioid consumption counteracts this effect and may impair metabolic function. Here we addressed the role of metabolic processes in the course of the agonist medication-assisted treatment for opioid use disorder (OUD) with buprenorphine or methadone. Plasma lipids, hemoglobin A1C, body composition, the oral glucose tolerance test (oGTT) and the Sweet Taste Test (STT) were measured in buprenorphine- (n = 26) or methadone (n = 32)- treated subjects with OUD. On the whole, the subjects in both groups were overweight or obese and insulin resistant; they displayed similar oGTT and STT performance. As compared to methadone-treated subjects, those on buprenorphine had significantly lower rates of metabolic syndrome (MetS) along with better values of the high-density lipoproteins (HDL). Subjects with- vs. without MetS tended to have greater addiction severity. Correlative analyses revealed that more buprenorphine exposure duration was associated with better HDL and opioid craving values. In contrast, more methadone exposure duration was associated with worse triglycerides-, HDL-, blood pressure-, fasting glucose- and hemoglobin A1C values. Buprenorphine appears to produce beneficial HDL- and craving effects and, contrary to methadone, its role in the metabolic derangements is not obvious. Our data call for further research aimed at understanding the distinctive features of buprenorphine metabolic effects vis-à-vis those of methadone and their potential role in these drugs’ unique therapeutic profiles.
Funder
Veterans Health Administration
National Institute on Alcohol Abuse and Alcoholism
Publisher
Springer Science and Business Media LLC
Reference143 articles.
1. World Drug Report., (United Nations, United Nations Office on Drugs and Crime, May 2016).
2. Collaborators, U. S. B. O. D. et al. The State of US Health, 1990-2016: Burden of Diseases, Injuries, and Risk Factors Among US States. JAMA 319, 1444–1472, https://doi.org/10.1001/jama.2018.0158 (2018).
3. Pierce, M., Bird, S. M., Hickman, M. & Millar, T. National record linkage study of mortality for a large cohort of opioid users ascertained by drug treatment or criminal justice sources in England, 2005–2009. Drug. Alcohol. Depend. 146, 17–23, https://doi.org/10.1016/j.drugalcdep.2014.09.782 (2015).
4. Odds of Dying, https://injuryfacts.nsc.org/all-injuries/preventable-death-overview/odds-of-dying/ (2017).
5. Vallecillo, G. et al. Metabolic syndrome among individuals with heroin use disorders on methadone therapy: Prevalence, characteristics, and related factors. Subst. Abus. 39, 46–51, https://doi.org/10.1080/08897077.2017.1363122 (2018).
Cited by
21 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献