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. Author manuscript; available in PMC: 2023 Sep 1.
Published in final edited form as: Drug Alcohol Depend. 2022 Jul 16;238:109575. doi: 10.1016/j.drugalcdep.2022.109575

Sex differences in weight gain during medication-based treatment for opioid use disorder: a meta-analysis and retrospective analysis of clinical trial data

Peter Manza 1, Danielle Kroll 1, Katherine L McPherson 1, Allison Johnson 1, Evan Dennis 1, Lianne Hu 2, Betty Tai 2, Nora D Volkow 1
PMCID: PMC9444983  NIHMSID: NIHMS1826410  PMID: 35868182

Abstract

Background:

Side effects of medications for opioid use disorder (MOUD) such as weight gain contribute to their stigma. Substantial evidence suggests that women have a more severe side effect profile to MOUD than men, and concerns about weight gain during treatment are prevalent. However, the few studies reporting sex differences in weight gain during treatment show conflicting results and are restricted to methadone. In addition, little is known about possible sex differences in weight gain to buprenorphine, which is the most commonly prescribed MOUD in the United States.

Methods:

To address these issues, we performed a systematic review and meta-analysis on the few studies reporting longitudinal data on sex differences in body mass index (BMI) gain during methadone treatment (Study 1). In a separate study, we also re-analyzed data from trial CTN-0030 of the National Institute on Drug Abuse Clinical Trial Network (NIDA CTN), which involved a 12-week buprenorphine treatment regimen (Study 2; n = 360; 209 Male, 151 Female).

Results:

For Study 1, across all papers reporting longitudinal data (k = 4, n = 362 OUD patients), revealed BMI increases that ranged from 2.2 to 5.4 BMI after at least one year of methadone treatment, but there were no significant sex differences in BMI increases (Standardized Mean Difference, Female > Male = 0.352, SE = .270; 95% CI = [−0.18 0.88]; p = .193). Study 2 showed no significant differences in weight before and after 12 weeks of buprenorphine treatment nor did it show sex differences in weight change with treatment (β = 2.34, p = .511).

Conclusion:

These analyses corroborate evidence of weight gain with methadone treatment but did not observe a sex-based disparity in weight gain with methadone or buprenorphine treatment for OUD.

Keywords: addiction, recovery, medication assisted therapy, side effects, opiates, adiposity

1. Introduction

Opioid Use Disorder (OUD) is a public health crisis in the United States, with overdose deaths reaching an all-time high in 2021 (Ahmad et al., 2022) and costing over one trillion dollars in 2017 alone (Florence et al., 2021). Medications for OUD (MOUD) including methadone and buprenorphine remain the standard of care, greatly improving outcomes and reducing risk of overdose deaths (Sordo et al., 2017; Timko et al., 2016). Though medications to treat OUD remain highly underutilized overall (Substance Abuse and Mental Health Services Administration., 2017), their use has increased in recent years (Brown et al., 2021), prompting a need to describe the social and biological determinants of health that affect treatment outcomes and side effect profiles.

A problematic side effect of methadone and buprenorphine treatment is weight gain (Baykara and Alban, 2019; Sadek et al., 2016; Schlienz et al., 2018), since being overweight or obese increases the risk for metabolic and cardiovascular diseases and of various cancers (GBD 2015 Obesity Collaborators, 2017). Although prevalence of obesity among people with an active OUD is less than in the general population (Hu et al., 2018), upon entering treatment many people transition from a healthy weight to overweight or obese (Sweeney et al., 2019).

Importantly, these medications may have stronger effects in women than in men. Females have a greater analgesic response to opioids than males (Fillingim and Gear, 2004) and more beneficial effects of MOUD treatment: after seven years of buprenorphine treatment and after 25 years of methadone treatment, women had higher rates of heroin abstinence than men (Jimenez-Treviño et al., 2011; Öhlin et al., 2015). These differences may be due to sex differences in pharmacokinetics, since women and men seem to metabolize methadone and buprenorphine at different rates (de Vos et al., 1995; Preston et al., 2003; Talal et al., 2020). Not surprisingly, many of the undesirable side effects of MOUD are also more prevalent in women than men (Haber et al., 2017). In particular, some studies suggest that females gain more weight than males after entering into a methadone-based treatment program (Fenn et al., 2015; Sweeney et al., 2019; Vallecillo et al., 2018), though this has not always been observed (Parvaresh et al., 2015; Peles et al., 2016), and in general sample sizes have been small. Little is known about sex differences in weight gain associated with buprenorphine therapy. Nevertheless, women report that fear of gaining weight is a major issue; among 297 women in treatment for various substance use disorders between 2008–2011, 70% reported concerns about weight gain during their treatment attempt, and over 30% reported concerns about using drugs to lose weight after leaving treatment (Warren et al., 2013). Together these findings suggest this issue deserves further study.

To reconcile differences across studies in possible sex differences in weight gain to methadone, we performed a systematic review and meta-analysis (Study 1). In a second study (Study 2), we determined if buprenorphine treatment for OUD was associated with sex differences in weight gain, by retrospective analysis of the data from a clinical buprenorphine trial performed by the The National Drug Abuse Clinical Trials Network (NIDA-CTN) (Weiss et al., 2011). With these complementary approaches, we sought to lend insight into our understanding of potential sex differences in the weight gain observed with MOUD treatment.

2. Materials and Methods

2.1. Study 1: Meta-Analysis of Studies on Weight Gain Associated with Methadone Treatment

This meta-analysis was pre-registered on Prospero in September 2020 and conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines (Moher et al., 2009). We sought to identify studies that reported change in weight or change in BMI in adult men and women with a history of opioid use who were maintained on MOUD. More details on search terms, criteria, and analysis are in the Supplement.

Meta-analysis was performed using the metafor package in R (Viechtbauer, 2010) to assess for sex differences in standardized mean difference of weight gain during methadone treatment using a random-effects model. We calculated the effect size (Hedges’ g) of mean between-group (Male vs Female) differences in weight/BMI change.

Data availability.

The datasets analyzed during the current study were acquired from the references listed in Supplementary Table 1. All data and R code to analyze the data are posted in a publicly available repository: https://github.com/pmanza/OUD-WeightGain.

2.2. Study 2: Re-analysis of CTN Data on Weight Gain Associated with Buprenorphine Treatment

Retrospective analysis of data from the CTN-0030 trial (Two-Phase Randomized Controlled Trial of Buprenorphine/Naloxone Treatment Plus Individual Drug Counseling for Opioid Analgesic Dependence; Weiss et al., 2011) was conducted to determine if buprenorphine treatment for OUD was associated with weight gain and whether weight change due to treatment differed between males and females. More details of the two-phase trial and analysis are in the Supplement and the summary of trial participant characteristics is in Supplementary Table 2.

Analyses were conducted in SAS 9.4 (SAS Institute, Cary, NC). We first used paired t-tests to test for differences in weight change during the trial without the influence of any other variables. We then used SAS General Linear Modeling (GLM) regression models designed to examine the effect of sex on change in weight (post-pre), with two other key variables: 1) buprenorphine exposure proportion, i.e. the number of buprenorphine doses taken by a participant divided by doses prescribed, and 2) duration in trial measured in weeks from the beginning of the phase. For each trial, we first tested the effects of two treatment-by-sex interactions on weight change; that is, the buprenorphine exposure proportion-by-sex interaction, and the duration in trial-by-sex interaction. We then tested a second model without the interaction terms, in which we only explored the main effects of sex, buprenorphine exposure proportion, and duration in trial. All data from this trial are reported in weight (pounds) because BMI was not available.

Data availability.

CTN datasets are publicly available at their website: https://datashare.nida.nih.gov/study/nida-ctn-0030

3. Results

3.1. Study 1: Meta-Analysis of Studies on Weight Gain Associated with Methadone Treatment

Four studies remained in the final analysis (Supplementary Table 1); all were in individuals taking methadone (n=362). Two of the four studies reported changes in weight, whereas all four reported changes in BMI, and therefore we report the results related to BMI changes. The meta-analysis revealed that, as previously reported (Fenn et al., 2015; Montazerifar et al., 2012; Mysels et al., 2018), there was an overall increase in BMI gain with at least one year of methadone treatment that ranged from 2.2 to 5.4 BMI. Though on average females had higher BMI increases than males after methadone treatment in three out of four studies, the sex difference in BMI gain was not significant (Standardized Mean Difference, Female > Male = 0.352, SE = .270; 95% CI = [−0.18 0.88]; p = .193; Figure 1). Heterogeneity and diagnostic testing results are in the Supplement.

Figure 1.

Figure 1.

Open in a new tab

Forest plot depicting the results from the meta-analysis of sex differences in BMI gain during methadone (MTD) treatment for opioid use disorder. Across the four studies there was not a significant sex difference in BMI increases during methadone treatment.

Note: SMD = Standardized Mean difference; RE = Random Effects; F = Female; M = Male.

3.2. Study 2: Re-analysis of CTN Data on Weight Gain Associated with Buprenorphine Treatment

Paired t-tests showed that neither in the four-week Phase 1 trial nor in the 12-week Phase 2 trial was there significant weight change from baseline to the end of trial (Phase 1: mean/median body weight change = 0.2 LB/0.5 LB; t = −.86; p = .392; Phase 2: mean/median body weight change = 0.2 LB/0.0 LB; t = −.27; p = .789).

Table 1 shows results of the GLM regression analyses for both Phase 1 and Phase 2 trials of CTN-0030. Sex was not significantly associated with weight change. The interaction terms (buprenorphine exposure proportion-by-Sex and duration in trial-by-sex) were not significant and their inclusion in the model did not meaningfully alter the conclusions.

Table 1. Estimated Effects of sex, buprenorphine exposure, and trial duration on Weight Change, With and Without interactions, from CTN-0030.

Phase 1 was a four-week buprenorphine trial; Phase 2 was a 12-week buprenorphine trial conducted in those who did not successfully complete Phase 1. While we include results from both trials for completeness, for the purposes of this study we focused on results for Phase 2, since the Phase 1 duration (four weeks) was not long enough to match our criteria for the methadone meta-analysis study duration inclusion criterion (eight weeks).

CTN-0030 Phase 1 CTN-0030 Phase 2
Effect With 2 Interactions Without Interaction With 2 Interactions Without Interaction
Effect Type Beta P-value Beta P-value Beta P-value Beta P-value
Sex (Female is reference) 0.2478 −2.77 0.1783 0.3433 2.34 0.5105
BUP exposure proportion 0.3276 −1.99 0.2019 0.1434 −6.62 0.1151
Duration in trial (weeks) 0.0211 −3.82 0.0189 0.0376 1.84 0.0378
BUP exposure proportion × Sex 3.83 0.1081 -- -- −4.83 0.6508 -- --
Duration in trial × Sex −0.07 0.8043 -- -- −0.13 0.6721 -- --
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Note: BUP exposure proportion = the number of buprenorphine doses taken by a participant divided by the total number of doses prescribed to the participant.

4. Discussion

Here we performed a meta-analysis on longitudinal methadone studies and analyzed data from patients in a 12-week buprenorphine clinical trial. We corroborated previous finding of BMI increases after methadone treatment but found no significant evidence of sex differences in methadone- nor buprenorphrine-associated weight gain.

Weight gain has long been observed in association with MOUD (Baykara and Alban, 2019; Fenn et al., 2015; Mysels et al., 2018; Nolan and Scagnelli, 2007; Rajs et al., 2004). Several pharmacological and sociocultural factors have been hypothesized to contribute to weight gain during OUD treatment (see Supplement for discussion).

Our primary question was whether treatment-associated weight gain disproportionately affects women compared to men. If true, it could have relevance for understanding biological and/or sociocultural mechanisms behind weight gain in response to MOUD. Although several studies suggested that females gain more weight on methadone than males (Fenn et al., 2015; Sweeney et al., 2019; Vallecillo et al., 2018) some did not have longitudinal data (e.g., Vallecillo et al., 2018). Differences in pre-treatment weight and heterogeneity in treatment duration obscure these findings. Therefore we only included studies in the current meta-analysis that had longitudinal data. Our results showed no consistent sex differences in BMI gain across studies, in line with previous reports (Parvaresh et al., 2015; Peles et al., 2016). Only one study found strong sex differences in BMI gain in this analysis (Fenn et al., 2015). This sample was 98% Caucasian and based in New England USA, whereas the other studies were conducted in Israel (Peles et al., 2016), Canada (Sadek et al., 2016) and Baltimore USA (Sweeney et al., 2019). Notably, Sweeney et al., (2019) found that race and tobacco/cocaine use contributed to weight gain during methadone treatment. Thus, differences in study samples may drive discrepancies across studies. Although sex differences in the use of psychotropic medications known to promote weight gain (e.g. antidepressants) could impact findings, for prior studies have shown that women in MOUD programs are prescribed antidepressants more often than men (as reviewed in Huhn et al., 2018). Since we did not observe significant sex differences in weight gain despite this observation, it may not have played a major role in the findings here.

Finally, we did not observe a main effect of weight gain with buprenorphine treatment, nor of sex differences in weight gain. Compared to methadone, there is little data on how buprenorphine affects weight gain. In line with the findings of a recent review (Schlienz et al., 2018) we are unaware of any other randomized clinical trials that assessed weight gain and sex differences in response to buprenorphine treatment. One recent study documented weight gain in OUD patients (n = 107) after four months on buprenorphine treatment (Baykara and Alban, 2019). Additionally, a report comparing buprenorphine (n=26) to methadone (n=32) treatment over 2–3 years showed no differences in BMI and sweet taste preference (Elman et al., 2020). However rates of metabolic syndrome were higher in the methadone group compared to the buprenorphine group (Elman et al., 2020). Another recent study compared 19 buprenorphine patients to 21 methadone patients and similarly found no significant differences in sucrose pleasantness or intensity, and did not report on differences in BMI (Ochalek et al., 2021). Thus, while there is clear data that methadone treatment is associated with increases in BMI with possible metabolic consequences, there remains comparatively little clinical data on buprenorphine. Further complicating this issue are significant differences in access to methadone versus buprenorphine across individuals, including underrepresented minorities (Hansen and Roberts, 2012) who might have greater biological and social risk factors for weight gain and obesity.

Limitations.

The number of studies with data available for meta-analysis was small, precluding us from performing meta-regression to see if smoking status, age, medication dose, use of other psychotropic medications, and comorbid conditions like diabetes impacted sex differences in weight gain. We recommend that future clinical trials of MOUD obtain anthropometric measurements and moderating variables at treatment initiation and at various follow-up timepoints. In addition, the buprenorphine trial was only 12 weeks long. However, a methadone study found that substantial increases in weight were observed after only eight weeks into treatment (Montazerifar et al., 2012).

In summary, while we corroborate increase in BMI with methadone treatment we do not see consistent evidence for sex differences in weight gain during methadone or buprenorphine treatment. Further data is required to determine if buprenorphine treatment is associated with weight gain.

Supplementary Material

1

Highlights.

  • Meta-analysis of sex differences in weight gain during methadone treatment

  • Analysis of sex differences in weight gain during a buprenorphine clinical trial

  • Weight gain appears to occur generally during opioid agonist treatment

  • However, neither analysis showed significant sex differences in weight gain

Acknowledgements.

We thank Alicia Livinski, Junfeng Sun, and Paul Juneau for their help with planning and conducting the literature search, and Paul Van Veldhuisen and Dr. Neil Oden for their help with analysis of the CTN data. We also thank the investigators of CTN-0030.

Funding and Disclosure.

This work was accomplished with support from the National Institute on Alcohol Abuse and Alcoholism (Y1AA-3009). The authors have nothing to disclose.

Footnotes

Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Conflict of interest statement

No conflict declared.

CRediT authorship contribution statement

LH and BT performed statistical analysis and oversaw the study, PM and NDV conceived of and oversaw the study, DK, KLM, AJ, and ED performed literature review and statistical analysis, PM wrote the first draft of the manuscript, All authors edited the manuscript and approve of the final article.

References

  1. Ahmad F, Rossen L, Sutton P, 2022. Provisional drug overdose death counts. National Center for Health Statistics. [Google Scholar]
  2. Baykara S, Alban K, 2019. The effects of buprenorphine/naloxone maintenance treatment on sexual dysfunction, sleep and weight in opioid use disorder patients. Psychiatry Res. 272, 450–453. 10.1016/j.psychres.2018.12.153 [DOI] [PubMed] [Google Scholar]
  3. Brown E, Schutze M, Taylor A, Jorgenson D, McGuire C, Brown A, Middleton A, Woodcock C, LaPres M, Cohn L, Dowler S, Sandoe E, Rose R, Applegate M, Markman K, Rizzutti M, Truex-Powell E, Ashmead R, Mack A, Bailey E, Kelley D, James AE, Costlow M, Sharbaugh M, Harrell A, Walker L, Becker J, Parsons C, Cai Y, Tyska S, Voskuil K, Donohue JM, Jarlenski MP, Kim JY, Tang L, Ahrens K, Allen L, Austin A, Barnes AJ, Burns M, Chang C-CH, Clark S, Cole E, Crane D, Cunningham P, Idala D, Junker S, Lanier P, Mauk R, McDuffie MJ, Mohamoud S, Pauly N, Sheets L, Talbert J, Zivin K, Gordon AJ, Kennedy S, 2021. Use of Medications for Treatment of Opioid Use Disorder Among US Medicaid Enrollees in 11 States, 2014–2018. JAMA 326, 154. 10.1001/jama.2021.7374 [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. de Vos JW, Ufkes JGR, van Wilgenburg H, Geerlings PJ, van den Brink W, 1995. Pharmacokinetics of methadone and its primary metabolite in 20 opiate addicts. Eur. J. Clin. Pharmacol 48, 361–366. 10.1007/BF00194951 [DOI] [PubMed] [Google Scholar]
  5. Elman I, Howard M, Borodovsky JT, Mysels D, Rott D, Borsook D, Albanese M, 2020. Metabolic and Addiction Indices in Patients on Opioid Agonist Medication-Assisted Treatment: A Comparison of Buprenorphine and Methadone. Sci. Rep 10, 5617. 10.1038/s41598-020-62556-0 [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Fenn JM, Laurent JS, Sigmon SC, 2015. Increases in body mass index following initiation of methadone treatment. J. Subst. Abuse Treat 51, 59–63. 10.1016/j.jsat.2014.10.007 [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Fillingim RB, Gear RW, 2004. Sex differences in opioid analgesia: Clinical and experimental findings. Eur. J. Pain 8, 413–425. 10.1016/j.ejpain.2004.01.007 [DOI] [PubMed] [Google Scholar]
  8. Florence C, Luo F, Rice K, 2021. The economic burden of opioid use disorder and fatal opioid overdose in the United States, 2017. Drug Alcohol Depend. 218, 108350. 10.1016/j.drugalcdep.2020.108350 [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. GBD 2015 Obesity Collaborators, 2017. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N. Engl. J. Med 377, 13–27. 10.1056/NEJMoa1614362 [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Haber PS, Elsayed M, Espinoza D, Lintzeris N, Veillard A-S, Hallinan R, 2017. Constipation and other common symptoms reported by women and men in methadone and buprenorphine maintenance treatment. Drug Alcohol Depend. 181, 132–139. 10.1016/j.drugalcdep.2017.09.024 [DOI] [PubMed] [Google Scholar]
  11. Hansen H, and Roberts KS 2012. Two Tiers of Biomedicalization: Methadone, Buprenorphine, and the Racial Politics of Addiction Treatment. In Critical Perspectives on Addiction, edited by Netherland Julie, 14:79–102. Advances in Medical Sociology. Emerald Group Publishing Limited. 10.1108/S1057-6290(2012)0000014008. [DOI] [Google Scholar]
  12. Hu L, Matthews A, Shmueli-Blumberg D, Killeen TK, Tai B, VanVeldhuisen P, 2018. Prevalence of obesity for opioid- and stimulant-dependent participants in substance use treatment clinical trials. Drug Alcohol Depend. 190, 255–262. 10.1016/j.drugalcdep.2018.06.014 [DOI] [PubMed] [Google Scholar]
  13. Jimenez-Treviño L, Saiz PA, García-Portilla MP, Díaz-Mesa EM, Sánchez-Lasheras F, Burón P, Casares MJ, Marina P, Gutiérrez E, Bobes J, 2011. A 25-year follow-up of patients admitted to methadone treatment for the first time: Mortality and gender differences. Addict. Behav 36, 1184–1190. 10.1016/j.addbeh.2011.07.019 [DOI] [PubMed] [Google Scholar]
  14. Moher D, Liberati A, Tetzlaff J, Altman DG, 2009. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. BMJ 339, 332–336. 10.1136/bmj.b2535 [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Montazerifar F, Karajibani M, Lashkaripour K, 2012. Effect of Methadone Maintenance Therapyon Anthropometric Indices in Opioid Dependent Patients. Int. J. High Risk Behav. Addict 1, 100–103. 10.5812/ijhrba.4968 [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Mysels DJ, Vosburg SK, Benga I, Levin FR, Sullivan MA, 2018. Course of weight change during naltrexone versus methadone maintenance for opioid-dependent patients. J. Opioid Manag 7, 47–53. 10.5055/jom.2011.0048 [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Nolan LJ, Scagnelli LM, 2007. Preference for sweet foods and higher body mass index in patients being treated in long-term methadone maintenance. Subst. Use Misuse 42, 1555–1566. 10.1080/10826080701517727 [DOI] [PubMed] [Google Scholar]
  18. Ochalek TA, Laurent J, Badger GJ, Sigmon SC, 2021. Sucrose subjective response and eating behaviors among individuals with opioid use disorder. Drug Alcohol Depend. 227, 109017. 10.1016/j.drugalcdep.2021.109017 [DOI] [PubMed] [Google Scholar]
  19. Öhlin L, Fridell M, Nyhlén A, 2015. Buprenorphine maintenance program with contracted work/education and low tolerance for non-prescribed drug use: A cohort study of outcome for women and men after seven years. BMC Psychiatry 15, 1–13. 10.1186/s12888-015-0415-z [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Parvaresh N, Sabahi AR, Mazhari S, Gilani H, 2015. A Study of the Sexual Function, Sleep, and Weight Status of Patients after 6 Months of Methadone Maintenance Treatment. Addict. Heal 7, 24–9. [PMC free article] [PubMed] [Google Scholar]
  21. Peles E, Schreiber S, Sason A, Adelson M, 2016. Risk factors for weight gain during methadone maintenance treatment. Subst. Abus 37, 613–618. 10.1080/08897077.2016.1179705 [DOI] [PubMed] [Google Scholar]
  22. Preston KL, Epstein DH, Davoudzadeh D, Huestis MA, 2003. Methadone and metabolite urine concentrations in patients maintained on methadone. J. Anal. Toxicol 27, 332–341. 10.1093/jat/27.6.332 [DOI] [PubMed] [Google Scholar]
  23. Rajs J, Petersson A, Thiblin I, Olsson-Mortlock C, Fredriksson Å, Eksborg S, 2004. Nutritional Status of Deceased Illicit Drug Addicts in Stockholm, Sweden—A Longitudinal Medicolegal Study. J. Forensic Sci 49, 1–10. 10.1520/jfs2003289 [DOI] [PubMed] [Google Scholar]
  24. Sadek GE, Chiu S, Cernovsky ZZ, 2016. Body composition changes associated with methadone treatment. Int. J. High Risk Behav. Addict 5, 5–7. 10.5812/ijhrba.27587 [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Schlienz NJ, Huhn AS, Speed TJ, Sweeney MM, Antoine DG, 2018. Double jeopardy: a review of weight gain and weight management strategies for psychotropic medication prescribing during methadone maintenance treatment. Int. Rev. Psychiatry 30, 147–154. 10.1080/09540261.2018.1509843 [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Sordo L, Barrio G, Bravo MJ, Indave BI, Degenhardt L, Wiessing L, Ferri M, Pastor-Barriuso R, 2017. Mortality risk during and after opioid substitution treatment: systematic review and meta-analysis of cohort studies. BMJ 357, j1550. 10.1136/bmj.j1550 [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Substance Abuse and Mental Health Services Administration., 2017. Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health (HHS Publication No. SMA 17–5044, NSDUH Series H-52). Rockville, MD. [Google Scholar]
  28. Sweeney MM, Antoine DG, Nanda L, Géniaux H, Lofwall MR, Bigelow GE, Umbricht A, 2019. Increases in body mass index and cardiovascular risk factors during methadone maintenance treatment. J. Opioid Manag 15, 367–374. 10.5055/jom.2019.0526 [DOI] [PubMed] [Google Scholar]
  29. Talal AH, Ding Y, Venuto CS, Chakan LM, McLeod A, Dharia A, Morse GD, Brown LS, Markatou M, Kharasch ED, 2020. Toward precision prescribing for methadone: Determinants of methadone deposition. PLoS One 15, 1–24. 10.1371/journal.pone.0231467 [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Timko C, Schultz NR, Cucciare MA, Vittorio L, Garrison-Diehn C, 2016. Retention in medication-assisted treatment for opiate dependence: A systematic review. J. Addict. Dis 35, 22–35. 10.1080/10550887.2016.1100960 [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Vallecillo G, Robles MJ, Torrens M, Samos P, Roquer A, Martires PK, Sanvisens A, Muga R, Pedro-Botet J, 2018. Metabolic syndrome among individuals with heroin use disorders on methadone therapy: Prevalence, characteristics, and related factors. Subst. Abus 39, 46–51. 10.1080/08897077.2017.1363122 [DOI] [PubMed] [Google Scholar]
  32. Viechtbauer W, 2010. Conducting meta-analyses in R with the metafor. J. Stat. Softw 36, 1–48. 10.18637/jss.v036.i03 [DOI] [Google Scholar]
  33. Warren CS, Lindsay AR, White EK, Claudat K, Velasquez SC, 2013. Weight-related concerns related to drug use for women in substance abuse treatment: Prevalence and relationships with eating pathology. J. Subst. Abuse Treat 44, 494–501. 10.1016/j.jsat.2012.08.222 [DOI] [PubMed] [Google Scholar]
  34. Weiss RD, Potter JS, Fiellin DA, Byrne M, Connery HS, Dickinson W, Gardin J, Griffin ML, Gourevitch MN, Haller DL, Hasson AL, Huang Z, Jacobs P, Kosinski AS, Lindblad R, McCance-Katz EF, Provost SE, Selzer J, Somoza EC, Sonne SC, Ling W, 2011. Adjunctive counseling during brief and extended buprenorphine-naloxone treatment for prescription opioid dependence: A 2-phase randomized controlled trial. Arch. Gen. Psychiatry 68, 1238–1246. 10.1001/archgenpsychiatry.2011.121 [DOI] [PMC free article] [PubMed] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

1
NIHMS1826410-supplement-1.docx (164.8KB, docx)

Data Availability Statement

The datasets analyzed during the current study were acquired from the references listed in Supplementary Table 1. All data and R code to analyze the data are posted in a publicly available repository: https://github.com/pmanza/OUD-WeightGain.

CTN datasets are publicly available at their website: https://datashare.nida.nih.gov/study/nida-ctn-0030

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