ArticleAddiction (Abingdon, England)2021
Sex differences in factors predicting post-treatment opioid use.
Article in Addiction (Abingdon, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
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Who cites it
29 citing papers in PubMed, 46 citations in OpenAlex.
- Trauma exposure across the lifespan among individuals engaged in treatment with medication for opioid use disorder: differences by gender, PTSD status, and chronic pain.Substance abuse treatment, prevention, and policy · 2024Trial
- The Impact of Heterogeneity in Individual Characteristics and Motivation to Quit Heroin Use on Contingency Management and Opioid Agonist Treatment Response: A Latent Class Analysis.Drug and alcohol review · 2026Article
- Central amygdalar PKCδ neurons mediate fentanyl withdrawal.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026Article
- Impact of study design decisions on identification of treatment initiators of medications for opioid use disorder.Addiction (Abingdon, England) · 2026Article
- Harm reduction engagement and ongoing opioid use among adults receiving methadone or buprenorphine in Philadelphia.Harm reduction journal · 2026Article
- Facilitators and Challenges in Oral Health Care for Iranian Patients Undergoing Opioid Maintenance Treatment: A Qualitative Study.Addiction & health · 2026Article
- Craving for a Robust Methodology: A Systematic Review of Machine Learning Algorithms on Substance-Use Disorders Treatment Outcomes.International journal of mental health and addiction · 2026Article
- Withdrawal-Induced Delirium in Opioid Dependence: A Systematic Review.Brain sciences · 2025Review
- Prescription opioid use and substance use disorder in US women (2006-2022): a retrospective cohort study.Lancet regional health. Americas · 2025Article
- Mental Health Consequences of Opioid Pain Medication Use Behaviors and Motives Among Adolescents and Young Adults With Cancer: Results From a National Survey.Psycho-oncology · 2025Article
- Comparison of Naltrexone Implant and Oral Buprenorphine Naloxone in The Treatment of Opioid Use Disorder: A Retrospective Cohort Study.Noro psikiyatri arsivi · 2025Article
- Global, regional and national burden of drug use disorders, 1990-2021: decomposition analysis, health inequality analysis and predictions to 2035.Frontiers in public health · 2025Article
- The nexus between gender, parental supervision, and opioid misuse among justice-involved adolescents.Journal of community psychology · 2024Article
- Barriers to opioid use disorder treatment among people who use drugs in the rural United States: A qualitative, multi-site study.Social science & medicine (1982) · 2024Article
- The cell-permeant antioxidant D-thiol ester D-cysteine ethyl ester overcomes physical dependence to morphine in male Sprague Dawley rats.Frontiers in pharmacology · 2024Article
- Sex differences in neonatal outcomes following prenatal opioid exposure.Frontiers in pediatrics · 2024Review
- The epigenetic signatures of opioid addiction and physical dependence are prevented by D-cysteine ethyl ester and betaine.Frontiers in pharmacology · 2024Article
- Trauma Exposure Across the Lifespan among Individuals Engaged in Treatment with Medication for Opioid Use Disorder: Differences by Gender, PTSD Status, and Chronic Pain.Research square · 2023Article
- A Novel Capacity-Strengthening Intervention for Frontline Harm Reduction Workers to Support Pre-exposure Prophylaxis Awareness-Building and Promotion Among People Who Use Drugs: Formative Research and Intervention Development.JMIR formative research · 2023Article
- Opioids and restless legs syndrome: a double-edged sword.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2023Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
Abstract
BACKGROUND AND
aimsSeveral reports have documented risk factors for opioid use following treatment discharge, yet few have assessed sex differences, and no study has assessed risk using contemporary machine learning approaches. The goal of the present paper was to inform treatments for opioid use disorder (OUD) by exploring individual factors for each sex that are most strongly associated with opioid use following treatment.
designSecondary analysis of Global Appraisal of Individual Needs (GAIN) database with follow-ups at 3, 6 and 12 months post-OUD treatment discharge, exploring demographic, psychological and behavioral variables that predict post-treatment opioid use.
settingOne hundred and thity-seven treatment sites across the United States.
participantsAdolescents (26.9%), young adults (40.8%) and adults (32.3%) in treatment for OUD. The sample (n = 1,126) was 54.9% male, 66.1% white, 20% Hispanic, 9.8% multi-race/ethnicity, 2.8% African American and 1.3% other. MEASUREMENT: Primary outcome was latency to opioid use over 1 year following treatment admission.
resultsFor women, regularized Cox regression indicated that greater withdrawal symptoms [hazard ratio (HR) = 1.31], younger age (HR = 0.88), prior substance use disorder (SUD) treatment (HR = 1.11) and treatment resistance (HR = 1.11) presented the largest hazard for post-treatment opioid use, while a random survival forest identified and ranked substance use problems [variable importance (VI) = 0.007], criminal justice involvement (VI = 0.006), younger age (VI = 0.005) and greater withdrawal symptoms (VI = 0.004) as the greatest risk factors. For men, Cox regression indicated greater conduct disorder symptoms (HR = 1.34), younger age (HR = 0.76) and multiple SUDs (HR = 1.27) were most strongly associated with post-treatment opioid use, while a random survival forests ranked younger age (VI = 0.023), greater conduct disorder symptoms (VI = 0.010), having multiple substance use disorders (VI = 0.010) and criminal justice involvement (VI = 0.006) as the greatest risk factors.
conclusionRisk factors for relapse to opioid use following opioid use disorder treatment appear to be, for women, greater substance use problems and withdrawal symptoms and, for men, younger age and histories of conduct disorder and multiple substance use disorder.
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