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Recovery Goals and Long-term Treatment Preference in Persons Who Engage in Nonmedical Opioid Use

Hay, Kaitlyn R. MS; Huhn, Andrew S. PhD, MBA; Tompkins, David Andrew MD, MHS; Dunn, Kelly E. PhD

doi: 10.1097/ADM.0000000000000498
Original Research

Background: While most opioid use disorder (OUD) treatment providers consider opioid abstinence to be the preferred outcome, little is known about the treatment preferences of the larger population of individuals who engage in nonmedical opioid use and have not yet sought treatment. This study sought to descriptively quantify the proportion of out-of-treatment individuals with nonmedical opioid use that have abstinent and nonabstinent recovery goals.

Methods: Participants (N = 235) who engage in nonmedical opioid use and met self-reported criteria for OUD were recruited online and participated in a cross-sectional survey on recovery goals and treatment perceptions. Participants were dichotomized as having either abstinent (70.6%) or nonabstinent (29.4%) recovery goals. Participants were presented with 13 treatment options and asked which treatment they would “try first” and which treatment they thought would be the best option for long-term recovery.

Results: Persons in the nonabstinent group were more likely to want to continue use of prescription opioids as prescribed by a physician compared with the abstinent group (χ2[1] = 9.71, P = 0.002). There were no group differences regarding preference for individual OUD treatments. The most frequently endorsed treatments that participants would “try first” were physician visits (23.4%), one-on-one counseling (18.7%), and 12-step groups (13.2%), whereas the most frequently endorsed treatments for long-term recovery were one-on-one counseling (17.4%), residential treatment (16.7%), and buprenorphine (15.3%).

Conclusion: Public health initiatives to engage out-of-treatment individuals should take into account recovery goals and treatment preferences to maximize treatment initiation and retention.

Behavioral Pharmacology Research Unit, Johns Hopkins School of Medicine, Baltimore, MD (KRH, ASH, DAT, KED); Department of Psychiatry, UCSF School of Medicine, San Francisco, CA (DAT).

Send correspondence to Andrew S. Huhn, PhD, MBA, Behavioral Pharmacology Research Unit, Johns Hopkins School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224. E-mail:

Received 17 May, 2018

Accepted 16 December, 2018

Funding: The work described in this manuscript was funded by the National Institute on Drug Abuse: NIDA R21DA035327 (Dunn) and R01DA035246 (Dunn).

Conflicts of interest: DAT has received medication supplies from Indivior for an investigator initiated study, served as a site PI for a multisite clinical trial funded by Alkermes, and served on a scientific advisory board for Alkermes.

The other authors have no conflicts of interest to disclose.

© 2019 American Society of Addiction Medicine