Cited by 45Opioid Use Disorder TreatmentSubstance Abuse Treatment and OutcomesNeuropeptides and Animal Physiology

Stress and opioid use disorder: A systematic review

MacLean, R. Ross, Armstrong, Jessica L., Sofuoglu, Mehmet·2019·Addictive Behaviors

Abstract

Medication assisted treatment (MAT) is highly effective in reducing illicit opioid use and preventing overdose in individuals with opioid use disorder (OUD); however, treatment retention of patients engaged in MAT is a significant clinical concern. The experience of stress may contribute to a decision to drop out of treatment. The current study is a systematic review conducted across multiple databases of empirical studies on primary appraisal of stress and its relationship to opioid craving, opioid use, and OUD treatment outcomes. Primary appraisal of stress is defined as an explicit inquiry into individual perception of feeling stressed using a self-report measure administered in laboratory, clinical, or naturalistic environment. A total of 21 included studies were organized into three categories: observed stress, experimentally-induced stress, and stress-focused interventions. Appraised stress was generally associated with greater craving, but associations with opioid use and treatment retention were mixed. All but one study included MAT samples and every study sample included some form of drug counseling. These findings suggest that individuals experience considerable stress in spite of receiving standard treatment for OUD. Psychopharmacological interventions targeting stress were promising, but no behavioral interventions specific to stress management were found. The preliminary results with clonidine and lofexidine targeting stress in individuals with OUD warrant further studies. To better understand the impact of stress in OUD, future research should consider using repeated assessment of stress in the context of daily life. Utilization of behavioral treatments specifically targeting stress could have benefits in improving OUD outcomes.

Integrity signals

Registry

Crossref · 10.1016/j.addbeh.2019.05.034

Cites

100 of 100 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Authors
MacLean, R. R., Armstrong, J. L., & Sofuoglu, M.
Affiliations
Yale University (US)
Corresponding author
MacLean, R. Ross
Venue
Addictive Behaviors
Publisher
Elsevier BV
Published
2019-11
Volume
98
Pages
106010
ISSN
0306-4603 (ISSN-L)
OpenAlex
W2947787073
Cited by
43
References
99
Citations by year
2026: 2 · 2025: 9 · 2024: 6 · 2023: 6 · 2022: 8 · 2021: 7 · 2020: 3 · 2019: 1 · 2013: 1
FWCI
0.78
Type
journal article
Language
en
Open access
closed
Locations
  • Addictive Behaviors (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuropeptides and Animal Physiology
Keywords
opioid use disorder, stress, medication-assisted treatment, treatment retention, opioid craving, drug counseling, clonidine, lofexidine, stress management interventions
MeSH terms
Ecological Momentary Assessment, Retention in Care, Counseling, Humans, Opioid-Related Disorders, Stress, Psychological, Opiate Substitution Treatment, Craving

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review