Opioid relapse scope more in risk tolerant people

People undergoing treatment for opioid addiction are more likely to relapse when they become more tolerant of risks, says a study. The findings can improve clinical monitoring in addiction treatment.

"Although it is well known that people addicted to opioids cycle through periods of abstinence and use, we lack the tools needed to prospectively identify when these transitions are more likely to occur," said researchers.

"Here, given that opioid use during treatment is quite risky, we wanted to examine whether a patient's tolerance for risky decisions is informative about their vulnerability to relapse," researchers said.

In the study, researchers followed 70 people during their first seven months of treatment for opioid addiction. Forty-six per cent returned to opioid use during that time. Most relapses occurred when patients exhibited a strong tolerance for risk-taking in situations where the risk associated with these decisions was not fully knowable, according to their performance in a computer game created for the study.

The relapse rate for substance use disorders is estimated to be between 40 per cent and 60 per cent.

Each patient completed up to 15 study visits over 7 months, during which they had an opportunity to play computer game for financial rewards.The game required patients to make decisions that involved two types of risk: Known risk, in which they had complete information on likelihood of a decision's outcome to lead to reward; and ambiguous risk, in which they did not have full information.

The researchers measured the test results against clinical assessments of the patient's anxiety, craving, withdrawal and nonadherence to treatment.

Opioid use was determined by random urine tests and self-reporting.

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