Cannabis-positive urine tests predicted noncompliance with opioid addiction treatment
Among veterans receiving buprenorphine for opioid addiction, positive urine tests for marijuana and benzodiazepines, being a smoker, and psychiatric comorbidity were all associated with treatment noncompliance.
Quick Facts
What This Study Found
In a review of 69 veteran patients receiving buprenorphine maintenance for opioid use disorder, researchers found that positive urine drug screens for marijuana and benzodiazepines, along with being a cigarette smoker, were significantly associated with noncompliance (inaccurate pill counts).
Psychiatric comorbidity was also independently associated with noncompliance. However, despite noncompliance with pill counts, patients were generally still taking their prescribed buprenorphine (confirmed by positive urine tests) and had high rates of negative screens for opioids and cocaine.
Key Numbers
69 patients analyzed from 209 total. Cannabis, benzodiazepines, and smoking were significant predictors (F = 3.08, P = .03). Psychiatric comorbidity was independently significant (F = 4.88, P = .03).
How They Did This
Retrospective chart review of 69 patients (from 209 total) in a VA Medical Center buprenorphine maintenance program (2006-2013). Multiple linear regression identified predictors of noncompliance defined by inaccurate pill count callbacks.
Why This Research Matters
Identifying risk factors for treatment noncompliance helps clinicians provide more targeted support. Cannabis use during buprenorphine treatment may indicate broader patterns of difficulty with treatment adherence.
The Bigger Picture
The question of whether cannabis use should be tolerated during opioid addiction treatment is debated in clinical practice. This study suggests cannabis use is a marker for noncompliance, though it does not establish whether cannabis use itself causes the noncompliance or simply co-occurs with it.
What This Study Doesn't Tell Us
Very small sample of 69 patients from a single VA center. Retrospective design with chart review limitations. Only 69 of 209 patients had pill count callbacks, introducing selection bias. Noncompliance was defined narrowly by pill count accuracy.
Questions This Raises
- ?Does cannabis use directly undermine opioid treatment adherence, or is it a marker for other factors?
- ?Should cannabis-positive urines trigger more intensive support rather than treatment consequences?
- ?Would addressing cannabis use improve buprenorphine treatment outcomes?
Trust & Context
- Key Stat:
- Cannabis-positive urines significantly predicted buprenorphine treatment noncompliance
- Evidence Grade:
- Small retrospective chart review at a single center. Identifies associations but cannot establish causation.
- Study Age:
- Published in 2014.
- Original Title:
- Factors affecting noncompliance with buprenorphine maintenance treatment.
- Published In:
- Journal of addiction medicine, 8(5), 345-50 (2014)
- Authors:
- Fareed, Ayman, Eilender, Pamela, Ketchen, Bethany, Buchanan-Cummings, Ann Marie, Scheinberg, Kelly, Crampton, Kelli, Nash, Abigail, Shongo-Hiango, Hilaire, Drexler, Karen
- Database ID:
- RTHC-00793
Evidence Hierarchy
Looks back at existing records to find patterns.
What do these levels mean? →Frequently Asked Questions
Does marijuana use affect opioid addiction treatment?
In this study, veterans who tested positive for marijuana during buprenorphine treatment were more likely to be noncompliant with their medication regimen. However, the study could not determine whether cannabis directly caused the noncompliance.
Were patients still taking their buprenorphine despite noncompliance?
Yes. Despite inaccurate pill counts (the measure of noncompliance), patients generally had positive urine tests for buprenorphine, confirming they were still taking the medication, and had high rates of negative screens for opioids and cocaine.
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Cite This Study
https://rethinkthc.com/research/RTHC-00793APA
Fareed, Ayman; Eilender, Pamela; Ketchen, Bethany; Buchanan-Cummings, Ann Marie; Scheinberg, Kelly; Crampton, Kelli; Nash, Abigail; Shongo-Hiango, Hilaire; Drexler, Karen. (2014). Factors affecting noncompliance with buprenorphine maintenance treatment.. Journal of addiction medicine, 8(5), 345-50. https://doi.org/10.1097/ADM.0000000000000057
MLA
Fareed, Ayman, et al. "Factors affecting noncompliance with buprenorphine maintenance treatment.." Journal of addiction medicine, 2014. https://doi.org/10.1097/ADM.0000000000000057
RethinkTHC
RethinkTHC Research Database. "Factors affecting noncompliance with buprenorphine maintenan..." RTHC-00793. Retrieved from https://rethinkthc.com/research/fareed-2014-factors-affecting-noncompliance-with
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.