Opioid Use Disorder Treatments: An Evidence Map

• Published in: Drug and alcohol dependence Vol. 241; p. 109657
• Main Authors: Sugarman, Allison, Vittitow, Alexandria, Cheng, Anna, Malone, Mia, McDonald, Ryan, Pace, Nancy, Williams, Ololade, Tofighi, Babak, McNeely, Jennifer, Schatz, Daniel, Roberts, Timothy, Hey, Spencer Phillips, Garrity, Kathleen, Lindquist, Kristin, Lee, Joshua D.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.12.2022; Elsevier Science Ltd
• Subjects: Analgesics, Opioid - therapeutic use; Buprenorphine; Buprenorphine - therapeutic use; Case reports; Clinical outcomes; Clinical research; Clinical trials; Criminal justice; Data visualization; Drug abuse; Drug addiction; Evidence map; Heroin; Humans; Inclusions; Intervention; Judicial system; Literature reviews; Methadone; Methadone - therapeutic use; Naltrexone; Naltrexone - therapeutic use; Narcotics; Opiate Substitution Treatment - methods; Opioid use disorder; Opioid-Related Disorders - drug therapy; Opioid-Related Disorders - rehabilitation; Opioids; Overdose; Population studies; Research design; Research subjects; Scientific visualization; Substance use disorder; Systematic review; Visualization; Evidence map; Methadone; Buprenorphine; Opioid use disorder
• DOI: 10.1016/j.drugalcdep.2022.109657
• ISSN: 0376-8716; 1879-0046

Evidence maps are emerging data visualization of a systematic review. There are no published evidence maps summarizing opioid use disorder (OUD) interventions. 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. 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. 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. 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. •This opioid use disorder (OUD) evidence map allows researchers and clinicians to rapidly survey the entirety of the OUD literature through a publicly available digital resource.•The most well-studied OUD interventions to date are methadone, buprenorphine, and naltrexone medication treatments.•Evidence gaps include opioid agonist therapies other than buprenorphine and methadonesuch as hydromorphone.