Comparison of opiate use disorder patients with and without remission in terms of craving, sleep quality, sexual functions and quality of life

Introduction: The aim of our study was to compare opiate use disorder (OUD) patients with ongoing opiate use, OUD patients in remission with Buprenorphine/Naloxone (B/N) maintenance treatment and healthy controls in terms of cravings, sleep quality, sexual function and quality of life. Method: In our study, aged 18-50 years, not using psychotropic or antiviral drugs, not having chronic physical illness, diagnosed with OUD according to DSM-5 diagnostic criteria, 141 patients with ongoing opiate use, 141 patients in remission with B/N maintenance treatment for at least 6 months and 141 healthy volunteers were included. Participants were evaluated with the Structured Clinical Interview for DSM-5 Axis 1 Disorders (SCID-5) and urine toxicology results were analyzed. Sociodemographic Data Form, Substance Craving Scale (SCS), Pittsburgh Sleep Quality Index (PSQI), Arizona Sexual Experiences Scale (ASES) and Short Form 36 (SF36) were administered to 141 patients who were opiate positive in urine toxicology and 141 patients who were opiate negative and buprenorphine positive for at least 6 months. Sociodemographic Data Form, PSQI, ASES and SF36 were also administered to healthy controls. Results: In our study, the SCS score was significantly lower in patients in remission [median:1 (0-4)] compared to patients with continued opiate use [median:18 (14- 22)] (p<0.001). The PSQI scores of the three groups were significantly different (p<0.001), significantly higher in patients with ongoing opiate use compared to patients in remission (p<0.001), and significantly higher in patients in remission compared to healthy controls (p=0.008). The ASES scores of the three groups were significantly different (p<0.001), significantly higher in patients with ongoing opiate use compared to patients in remission (p<0.001), and significantly higher in patients in remission compared to healthy controls (p=0.031). SF36 all subgroup scores were significantly lower (p<0.001) in patients with ongoing opiate use compared to both patients in remission and healthy controls. In patients in remission, all subgroup scores except for the physical function subgroup were similar to healthy controls (p>0.05). When the three groups were compared according to the dose of B/N use in patients in remission (below 8 mg/day, 8-15 52 mg/day, 16 mg/day and above), SCS, PSQI, ASES and SF36 (except energy vitality subgroup) scores were found to be similar (p>0.05). In addition, no correlation was found between the dose of B/N use and the SCS score. Conclusion: As a result of our study, we can say that patients in remission with B/N maintenance therapy had significantly reduced cravings and had much better sleep quality, sexual function and quality of life compared to patients who continued to use opiates. No difference was found in terms of cravings, sleep quality, sexual functioning and quality of life of patients in remission according to the dose of B/N use. Therefore, each patient should be approached individually and individualized treatment should be considered when organizing maintenance treatment in order to increase the treatment compliance of patients and prolong the remission period.