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Using behavioral economics to predict opioid use during prescription opioid dependence treatment . 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 . 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 . 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 . 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 .
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Intervention_Pharmacological
buprenorphine-naloxone
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Intervention_Educational
counseling
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Outcome_Mental
opioid use
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Outcome_Mental
indices of drug reinforcement value
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Outcome_Other
Weekly urine drug screens
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Outcome_Mental
disrupted decision-making
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Outcome_Mental
reward-processing
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Participant_Condition
during prescription opioid dependence treatment .
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Participant_Condition
participants with prescription opioid dependence who received 12 weeks of buprenorphine-naloxone and counseling in a multi-site clinical trial
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Participant_Sample-size
N=353
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Participant_Condition
individuals with prescription opioid addiction