A method to diagnose opioid dependence resulting from heroin versus prescription opioids using the Composite International Diagnostic Interview.

Treatment research with opioid-dependent populations has not traditionally distinguished between those dependent on prescription opioids versus dependent upon heroin. Evidence suggests there is a substantial subpopulation of individuals with opioid dependence resulting largely or exclusively from prescription opioid use. Because this subpopulation may respond to treatment differently from heroin users, a method for discriminating DSM-IV opioid dependence due to prescription opioid use would provide more precision when examining this population. The Prescription Opioid Addiction Treatment Study (POATS) is a multi-site trial being conducted by investigators in the National Drug Abuse Treatment Clinical Trials Network (CTN). POATS examines different lengths and combinations of buprenorphine/naloxone (BUP/NX) and individual drug counseling to identify optimal treatment strategies for this patient population. In designing the study, several issues emerged, including how to identify potential participants with DSM-IV opioid dependence resulting from prescription opioid use and not heroin use. Because there was no pre-existing method available to accomplish this task, POATS researchers developed an innovative technique using a currently available diagnostic instrument, the Composite International Diagnostic Interview (CIDI). This method, which is relatively straight-forward and feasible, provides for a DSM-IV opioid dependence diagnosis as well as a means to attribute this diagnosis to prescription opioids and/or heroin. Improved diagnostic methods such as this one could aid clinical researchers conducting epidemiologic and treatment research with this population and help with interpreting the growing research literature on illicit use of prescription opioids.

Related protocols: CTN-0030