Opioid Use Disorder in Two Samples of the Lebanese Population: Scale Validation and Correlation with Sleep and Mood Disorders

Overview

Journal BMC Psychiatry

Publisher Biomed Central

Specialty Psychiatry

Date 2023 Nov 2

PMID 37914993

Authors

Karam Chamoun

Joseph Mouawad

Pascale Salameh

Hala Sacre

Ramzi Haddad

Lydia Rabbaa Khabbaz

Bruno Megarbane

Aline Hajj

Affiliations

Soon will be listed here.

Abstract

Background: The revised Opioid Risk Tool (ORT-OUD) is a brief, self-report scale designed to provide clinicians with a simple, validated method to screen for the risk of developing an Opioid Use Disorder (OUD) in patients without a prior history of substance abuse. This study aimed to translate and validate the Arabic version of ORT-OUD in the Lebanese population and assess its clinical validity in a sample of patients with OUD.

Methods: This cross-sectional study in the Lebanese population used several validated scales to assess the risk of OUD, including the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). Other tools evaluated chronotype and sleep and mood disturbances. Principal component analysis with Varimax rotation was applied to assess ORT-OUD construct validity. Convergent validity with the Arabic version of ASSIST was evaluated. The ORT-OUD criterion validity was then assessed in a clinical sample of patients with OUD.

Results: This study included 581 participants. The prevalence of the OUD risk in the Lebanese population using the ORT-OUD scale and the ASSIST-opioids scale was estimated at 14.5% and 6.54%, respectively. No items of the ORT-OUD were removed; all items converged over a solution of four factors with an eigenvalue > 1, explaining a total of 68.2% of the variance (Cronbach's alpha = 0.648). The correlation coefficients between the ORT-OUD total score and ASSIST subscales were as follows: ASSIST-opioids (r = 0.174; p = < 0.001), ASSIST-sedatives (r = 0.249; p < 0.001), and ASSIST-alcohol (r = 0.161; p = < 0.001). ORT-OUD clinical validation showed a correlation with ASSIST-opioids (r = 0.251; p = 0.093) and ASSIST-sedatives (r = 0.598; p < 0.001). Higher ORT-OUD scores were associated with a family and personal history of alcohol and substance consumption and higher insomnia and anxiety scores.

Conclusions: This study is the first to validate the Arabic version of ORT-OUD in the Lebanese population, an essential step towards improving the detection and management of OUD in this population.

Citing Articles

A lesson for post-COVID healthcare: assessment of physical and psychosocial risk factors on perceived pain intensity among urban individuals.

Ho H, Bai W, Wong S, Cheung C Front Psychol. 2025; 15:1447168.

PMID: 39886370 PMC: 11780548. DOI: 10.3389/fpsyg.2024.1447168.

Knowledge, Awareness, and Attitudes Regarding Self-Medication With Non-opioid Analgesics Among Students in Hafar Al-Batin, Saudi Arabia: A Cross-Sectional Study.

Mohammad Ismail E, Dabaan A, Almutairi G, Alhumidan F, Palani Sami M, Aldhafeeri G Cureus. 2024; 16(11):e73512.

PMID: 39669805 PMC: 11636046. DOI: 10.7759/cureus.73512.

References

Weissman M, Greenwald S, Dement W . The morbidity of insomnia uncomplicated by psychiatric disorders. Gen Hosp Psychiatry. 1997; 19(4):245-50. DOI: 10.1016/s0163-8343(97)00056-x. View

Rosoff D, Davey Smith G, Lohoff F . Prescription Opioid Use and Risk for Major Depressive Disorder and Anxiety and Stress-Related Disorders: A Multivariable Mendelian Randomization Analysis. JAMA Psychiatry. 2020; 78(2):151-160. PMC: 7658804. DOI: 10.1001/jamapsychiatry.2020.3554. View

Reid M, Weber M, Kerns R, Rogers E, OConnor P . Use of opioid medications for chronic noncancer pain syndromes in primary care. J Gen Intern Med. 2002; 17(3):173-9. PMC: 1495018. DOI: 10.1046/j.1525-1497.2002.10435.x. View

Picciotto M, Brunzell D, Caldarone B . Effect of nicotine and nicotinic receptors on anxiety and depression. Neuroreport. 2002; 13(9):1097-106. DOI: 10.1097/00001756-200207020-00006. View

McHugh R, DeVito E, Dodd D, Carroll K, Potter J, Greenfield S . Gender differences in a clinical trial for prescription opioid dependence. J Subst Abuse Treat. 2013; 45(1):38-43. PMC: 3626739. DOI: 10.1016/j.jsat.2012.12.007. View

Votaw V, Witkiewitz K, Valeri L, Bogunovic O, McHugh R . Nonmedical prescription sedative/tranquilizer use in alcohol and opioid use disorders. Addict Behav. 2018; 88:48-55. DOI: 10.1016/j.addbeh.2018.08.010. View

Butler S, Budman S, Fernandez K, Jamison R . Validation of a screener and opioid assessment measure for patients with chronic pain. Pain. 2004; 112(1-2):65-75. DOI: 10.1016/j.pain.2004.07.026. View

Morasco B, Dobscha S . Prescription medication misuse and substance use disorder in VA primary care patients with chronic pain. Gen Hosp Psychiatry. 2008; 30(2):93-9. DOI: 10.1016/j.genhosppsych.2007.12.004. View

Matuskey D, Pittman B, Forselius E, Malison R, Morgan P . A multistudy analysis of the effects of early cocaine abstinence on sleep. Drug Alcohol Depend. 2010; 115(1-2):62-6. PMC: 3081928. DOI: 10.1016/j.drugalcdep.2010.10.015. View

10.

Pierce M, Bird S, Hickman M, Millar T . National record linkage study of mortality for a large cohort of opioid users ascertained by drug treatment or criminal justice sources in England, 2005-2009. Drug Alcohol Depend. 2014; 146:17-23. PMC: 4294586. DOI: 10.1016/j.drugalcdep.2014.09.782. View

11.

Abouzeid M, Habib R, Jabbour S, Mokdad A, Nuwayhid I . Lebanon's humanitarian crisis escalates after the Beirut blast. Lancet. 2020; 396(10260):1380-1382. DOI: 10.1016/S0140-6736(20)31908-5. View

12.

Arrona-Palacios A, Diaz-Morales J, Adan A, Randler C . Sleep habits, circadian preferences and substance use in a Mexican population: the use of the Morningness-Eveningness-Stability-Scale improved (MESSi). Chronobiol Int. 2019; 37(1):111-122. DOI: 10.1080/07420528.2019.1688339. View

13.

Buysse D, Reynolds 3rd C, Monk T, BERMAN S, Kupfer D . The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989; 28(2):193-213. DOI: 10.1016/0165-1781(89)90047-4. View

14.

Breslau N, Roth T, Rosenthal L, Andreski P . Sleep disturbance and psychiatric disorders: a longitudinal epidemiological study of young adults. Biol Psychiatry. 1996; 39(6):411-8. DOI: 10.1016/0006-3223(95)00188-3. View

15.

Adams L, Gatchel R, Robinson R, Polatin P, Gajraj N, Deschner M . Development of a self-report screening instrument for assessing potential opioid medication misuse in chronic pain patients. J Pain Symptom Manage. 2004; 27(5):440-59. DOI: 10.1016/j.jpainsymman.2003.10.009. View

16.

Haney M, Ward A, Comer S, Foltin R, FISCHMAN M . Abstinence symptoms following oral THC administration to humans. Psychopharmacology (Berl). 1999; 141(4):385-94. DOI: 10.1007/s002130050848. View

17.

Koo T, Li M . A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. J Chiropr Med. 2016; 15(2):155-63. PMC: 4913118. DOI: 10.1016/j.jcm.2016.02.012. View

18.

Webster L, Webster R . Predicting aberrant behaviors in opioid-treated patients: preliminary validation of the Opioid Risk Tool. Pain Med. 2005; 6(6):432-42. DOI: 10.1111/j.1526-4637.2005.00072.x. View

19.

Huhn A, Finan P, Gamaldo C, Hammond A, Umbricht A, Bergeria C . Suvorexant ameliorated sleep disturbance, opioid withdrawal, and craving during a buprenorphine taper. Sci Transl Med. 2022; 14(650):eabn8238. DOI: 10.1126/scitranslmed.abn8238. View

20.

Miceli L, Bednarova R, Cuomo A, Cascella M, Guardamagna V, Romualdi P . Prescribing opioids to patients with chronic pain: translation of the Opioid Risk Tool into Italian. Minerva Anestesiol. 2020; 86(7):693-695. DOI: 10.23736/S0375-9393.20.14312-8. View