Opioid Use Disorder Treatments: An Evidence Map

Allison Sugarman; Alexandria Vittitow; Anna Cheng; Mia Malone; Ryan McDonald; Nancy Pace; Ololade Williams; Babak Tofighi; Jennifer McNeely; Daniel Schatz; Timothy Roberts; Spencer Phillips Hey; Kathleen Garrity; Kristin Lindquist; Joshua D Lee

doi:10.1016/j.drugalcdep.2022.109657

Opioid Use Disorder Treatments: An Evidence Map

Drug Alcohol Depend. 2022 Dec 1:241:109657. doi: 10.1016/j.drugalcdep.2022.109657. Epub 2022 Oct 14.

Authors

Affiliations

¹ New York University Grossman School of Medicine, Department of Population Health, USA.
² New York University Grossman School of Medicine, Department of Population Health, USA; New York University Grossman School of Medicine, Department of Medicine, USA.
³ New York University Grossman School of Medicine, Health Sciences Library, USA.
⁴ Center for Bioethics, Harvard Medical School, USA; Prism Analytic Technologies, USA.
⁵ Prism Analytic Technologies, USA.
⁶ New York University Grossman School of Medicine, Department of Population Health, USA; New York University Grossman School of Medicine, Department of Medicine, USA. Electronic address: joshua.lee@nyulangone.org.

PMID: 36332588
DOI: 10.1016/j.drugalcdep.2022.109657

Abstract

Background: Evidence maps are emerging data visualization of a systematic review. There are no published evidence maps summarizing opioid use disorder (OUD) interventions.

Aim: Our aim was to publish an interactive summary of all peer-reviewed interventional and observational trials assessing the treatment of OUD and common clinical outcomes.

Methods: PubMed, Embase, PsycInfo, Cochrane Central Register of Clinical Trials, and Web of Science were queried using multiple OUD-related MESH terms, without date limitations, for English-language publications. Inclusions were human subjects, treatment of OUD, OUD patient or community-level outcomes, and systematic reviews of OUD interventions. Exclusions were laboratory studies, reviews, and case reports. Two reviewers independently scanned abstracts for inclusion before coding eligible full-text articles by pre-specified filters: research design, study population, study setting, intervention, outcomes, sample size, study duration, geographical region, and funding sources.

Results: The OUD Evidence Map (https://med.nyu.edu/research/lee-lab/research/opioid-use-disorder-treatment-evidence-map) identified and assessed 12,933 relevant abstracts through 2020. We excluded 9455 abstracts and full text reviewed 2839 manuscripts; 888 were excluded, 1591 were included in the final evidence map. The most studied OUD interventions were methadone (n = 754 studies), buprenorphine (n = 499), and naltrexone (n = 134). The most common outcomes were heroin/opioid use (n = 708), treatment retention (n = 557), and non-opioid drug use (n = 368). Clear gaps included a wider array of opioid agonists for treatment, digital behavioral interventions, studies of OUD treatments in criminal justice settings, and overdose as a clinical outcome.

Conclusion: This OUD Evidence Map highlights the importance of pharmacologic interventions for OUD and reductions in opioid use. Future iterations will update results annually and scan policy-level interventions.

Keywords: Buprenorphine; Evidence map; Methadone; Opioid use disorder.

Publication types

Systematic Review

MeSH terms

Analgesics, Opioid / therapeutic use
Buprenorphine* / therapeutic use
Humans
Methadone / therapeutic use
Naltrexone / therapeutic use
Opiate Substitution Treatment / methods
Opioid-Related Disorders* / drug therapy
Opioid-Related Disorders* / rehabilitation

Substances

Analgesics, Opioid
Buprenorphine
Methadone
Naltrexone