Laura Zielinski, a second year MiNDS graduate student, proposes a systematic review protocol to examine the possible negative impacts of cannabis use on methadone maintenance treatment outcomes in individuals seeking treatment for opioid addiction.
North America is currently facing an opioid crisis and as a result, the demand for effective treatment of opioid addiction (or opioid use disorder) is growing. Methadone maintenance treatment (MMT) is an opioid substitution therapy whose purpose is to relieve withdrawal symptoms and diminish cravings, and is currently the most common treatment of opioid use disorder. Despite its popularity, patients on MMT continue to show high rates of opioid relapse and treatment attrition, however the reason for this remains unclear. MMT patients show disproportionately high rates of cannabis use (~50%) compared to the general population, which may have a negative impact on treatment outcomes. North America is also moving towards more liberal views of cannabis which may increase its use even further due to wider availability and reduced stigma. This coupled with the demand for a more effective treatment of opioid use disorder warrants an examination into the potential harms associated with cannabis use, particularly in such a vulnerable population. The current systematic review protocol outlines the aims and methods of a systematic review whose objective is to examine the association between cannabis use and MMT outcomes. We will summarize all literature investigating this association and assess the quality of evidence, as well as conduct a meta-analysis, if appropriate. Results of the upcoming review will be of use to clinicians as it will provide evidence on whether monitoring cannabis use during MMT is advantageous for optimizing MMT outcomes.
Citation: Zielinski, L., Bhatt, M., Eisen, R. B., Perera, S., Bhatnagar, N., MacKillop, J., Steiner, M., McDermid Vaz, S., Thabane, L., Samaan, Z. (2016). Association between cannabis use and treatment outcomes in patients receiving methadone maintenance treatment: A systematic review protocol. Systematic Reviews, 5, 139.
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