Personal recovery among people with opioid use disorder during treatment with extended-release naltrexone

Anne Marciuch; Bente Birkeland; Jūratė Šaltytė Benth; Kristin Klemmetsby Solli; Lars Tanum; Ida Mathisen; Bente Weimand

doi:10.1016/j.heliyon.2023.e17516

Personal recovery among people with opioid use disorder during treatment with extended-release naltrexone

Heliyon. 2023 Jul 5;9(7):e17516. doi: 10.1016/j.heliyon.2023.e17516. eCollection 2023 Jul.

Authors

Anne Marciuch^{1

2}, Bente Birkeland³, Jūratė Šaltytė Benth^{4

5}, Kristin Klemmetsby Solli^{1

6

7}, Lars Tanum^{1

8}, Ida Mathisen^{8

9}, Bente Weimand^{1

10}

Affiliations

¹ Department of Research and Development in Mental Health, Akershus University Hospital, Loerenskog, Norway.
² Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
³ Department of Psychosocial Health, University of Agder, Kristiansand, Norway.
⁴ Institute of Clinical Medicine, Campus Ahus, University of Oslo, Norway.
⁵ Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway.
⁶ Norwegian Centre for Addiction Research, University of Oslo, Norway.
⁷ Vestfold Hospital Trust, Toensberg, Norway.
⁸ Faculty for Health Science, Oslo Metropolitan University, Oslo, Norway.
⁹ Faculty of Health and Social Sciences, University of South-Eastern Norway, Norway.
¹⁰ Department of Health, Social and Welfare Studies, University of South-Eastern Norway, Drammen, Norway.

Abstract

Background and aims: Recovery from substance use disorders (SUD) has traditionally been equated with abstinence. "Personal recovery" however emphasizes recovery as a unique and personal process, supported by changes in connectedness, hope, identity, meaning and empowerment. This study aimed to examine personal recovery in people receiving extended-release naltrexone (XR-NTX); specifically investigate changes in personal recovery during treatment, identify groups of participants following distinct trajectories of recovery, and characteristics predicting group-belonging.

Methods: Overall change in recovery (Questionnaire about the Process of Recovery, QPR) score was assessed by linear mixed model in a subsample of 135 people with opioid use disorder (OUD) participating in a 24 + 28-week trial of XR-NTX. Growth mixture model was used to identify potential groups of people following distinct trajectories of personal recovery.

Results: Overall, there was a significant change in QPR score during treatment. Four groups with distinct recovery trajectories were identified: "initially low- increase" (G1), "initially average- no change" (G2), "initially high- no change" (G3) and "initially high- increase" (G4). The groups were different with regards to level of psychological distress, social support, and the use of benzodiazepines. In addition, previous participation in opioid agonist treatment programs, current pain, life satisfaction, employment, heroin craving and previous use of heroin also differed between groups.

Conclusions: Personal recovery among people receiving XR-NTX follows different trajectories, and various factors are associated with personal recovery. Particular attention regarding psychological distress, social support and heroin use among patients commencing XR-NTX treatment is important to facilitate successful recovery trajectories.

Keywords: Extended-release naltrexone; Opioid use disorder; Opioids; Personal recovery; QPR; XR-NTX.