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Placebo + Methadone Improves Opioid Use Disorder Treatment Retention

Conditioned open-label placebo had no impact on the 90-day methadone dose, but did improve sleep quality

By Lori Solomon HealthDay Reporter

TUESDAY, April 18, 2023 (HealthDay News) — A conditioned open-label placebo (C-OLP) may be a beneficial, low-risk adjunct to methadone treatment of opioid use disorder, according to a study published online April 12 in JAMA Network Open.

Annabelle M. Belcher, Ph.D., from University of Maryland in Baltimore, and colleagues examined the effect of a pharmacologically C-OLP on 90-day methadone dose, retention, drug use, withdrawal, craving, quality of life, and sleep. Participants (63.4 percent Black or African American and 64.1 percent men) in an academically affiliated community opioid treatment program were randomly assigned to C-OLP (pharmacologic conditioning and a placebo pill and methadone; 77 patients) or methadone only (treatment as usual; 54 patients) between Dec. 5, 2017, and Aug. 2, 2019.

The researchers found no significant group differences for the mean 90-day methadone dose (83.1 mg for methadone only versus 79.4 mg for group C-OLP). However, the groups differed significantly in their retention rates (61.1 percent remained in treatment at 90 days for methadone only versus 77.9 percent for C-OLP); the number needed to treat for the beneficial outcome of three-month treatment retention was six. Significantly better sleep quality was reported by C-OLP participants.

“To our knowledge, this is the first randomized clinical trial to assess the efficacy of a harnessed placebo intervention in a clinical opioid use disorder treatment context,” the authors write. “Our findings of C-OLP-enhanced treatment retention and ameliorated sleep merit further investigation, especially considering the unchecked opioid use disorder epidemic that continues in the United States.”

One author disclosed financial ties to the pharmaceutical and sleep technology industries.

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