Treatment for Opioid Use Disorders and Dissociative Symptoms

Opioid use has been associated with numerous psychiatric symptoms, including dissociative symptoms. Medications that are used to treat opioid use disorder can potentially impact dissociative symptoms, but this has not been explored in the existing literature. We intended to examine the relationship between dissociative symptoms and opioid use disorders using the Dissociative Experiences Scale (DES). We studied subjects who were prescribed methadone, buprenorphine or naltrexone for opioid use disorder. Surveys were given to subjects in three substance use treatment facilities: TCN Behavioral Health Services, Inc., Project C.U.R.E., Inc. and Access Ohio. All data were analyzed using SAS version 9.4 (Cary, NC) and p-values \u3c.05 were considered statistically significant. Analysis of Variance (ANOVA) was conducted to examine associations between the study variables and the outcome. A multiple linear regression model was developed to examine the association between opioid medication type and dissociative symptoms. There were 116 participants included in the analysis. Approximately 55% of participants were prescribed buprenorphine. The majority of participants were female (51.7%), white (89.5%), and ≤ 40 years of age (64.7%). The average dissociative symptoms score was 16.1 (standard deviation = 14.9) and 80.9% were considered to have low dissociation (score \u3c 30). There was a significant association between medication type and dissociative symptoms (p = .01). Participants prescribed buprenorphine had higher mean dissociation symptom scores (18.8) compared to methadone (12.7) and naltrexone (12.8). Their last use of alcohol or other drugs (p = .006) was significantly associated with dissociation symptoms. Overall, the multiple linear regression model was significant (F = 3.54; p = .003) and explained 11.8% of the variance. Compared to buprenorphine, both methadone (β = -0.479; p = .01) and naltrexone (β = 0.266; p = 0.007) had significantly lower dissociation scores, controlling for the other variables