Monitoring of chronic opioid use among people living with HIV does not conform to guidelines, a small study published in Clinical Infectious Diseases found.
Researchers interviewed 166 participants who attended one of two urban HIV clinics in the U.S. and were prescribed opioids at least three times, 21 days or more apart, during the prior six months. Ninety percent acknowledged the addictive potential of the medication and 43% scored high on a measure of potential opioid misuse known as COMM. Thirty percent reported signing an opioid treatment agreement, and 12% received pill counts. The urine of 66% of participants was tested for drugs at least once during their treatment, although it was unclear whether test results were followed up.
Guidelines recommend the concurrent use of three monitoring measures together -- an opioid treatment agreement, pill counts, and urine testing -- but this occurred in only 4.8% of participants. Those who were subject to one or more drug monitoring measure said they were highly satisfied with the monitoring.
According to safe prescribing practices, naloxone, an emergency medication to treat an opioid overdose, should be prescribed along with the opioid. Ten percent of participants reported receiving such a secondary prescription.
Study authors called for implementing guidelines on monitoring practices, as well as increasing naloxone distribution.