The influence of anxiety sensitivity on opioid use disorder treatment outcomes

Exp Clin Psychopharmacol. 2019 Feb;27(1):64-77. doi: 10.1037/pha0000215. Epub 2018 Aug 6.


Given the high rates of relapse among patients with opioid use disorder (OUD), it is crucial to identify modifiable risk factors for negative treatment outcomes. Anxiety sensitivity (AS) is 1 such risk factor that may be associated with negative OUD treatment outcomes. The present study examined the potential impact of AS on the withdrawal process, subsequent treatment engagement, and relapse among individuals with OUD. Adults undergoing inpatient detoxification (N = 90) completed self-report and researcher-administered questionnaires on Day 4 of a 5-day buprenorphine-assisted detoxification protocol, and 1 month later a follow-up evaluation assessed treatment engagement and relapse. Although 68% of the sample engaged in subsequent treatment, 76% demonstrated poor adherence. Over half the sample (57%) reported opioid relapse 1 month later. Results revealed that greater AS and younger age predicted greater fear of withdrawal during detoxification. Contrary to the research hypotheses, AS was not a significant predictor of other treatment outcomes; rather, fear of withdrawal and prior number of opioid detoxifications predicted greater subjective withdrawal severity. During detoxification, younger age was related to greater cravings, and being a male was associated with a higher likelihood of receiving prescription anxiolytics. Following detoxification treatment, referral to residential treatment predicted greater treatment engagement, whereas greater opioid craving, number of days in an uncontrolled environment, and any nonopioid substance use postdischarge predicted greater opioid relapse. Failure to find a relationship between AS and the withdrawal process is potentially a function of the buprenorphine protocol. Overall, findings may have important implications for the treatment of OUD. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

MeSH terms

  • Adult
  • Age Factors
  • Analgesics, Opioid / pharmacology
  • Anti-Anxiety Agents / administration & dosage*
  • Anxiety* / drug therapy
  • Anxiety* / psychology
  • Buprenorphine / therapeutic use
  • Craving / drug effects
  • Female
  • Humans
  • Male
  • Narcotic Antagonists / pharmacology
  • Opiate Substitution Treatment* / methods
  • Opiate Substitution Treatment* / psychology
  • Opioid-Related Disorders* / drug therapy
  • Opioid-Related Disorders* / psychology
  • Risk Factors
  • Secondary Prevention
  • Sex Factors
  • Substance Withdrawal Syndrome* / prevention & control
  • Substance Withdrawal Syndrome* / psychology
  • Treatment Failure
  • Young Adult


  • Analgesics, Opioid
  • Anti-Anxiety Agents
  • Narcotic Antagonists
  • Buprenorphine