Hedonic capacity in individuals treated with medications for Opioid Use Disorder

Background: Hedonic capacity (HC), or the ability to experience pleasure, may be impacted by opioid use disorder (OUD), and the restoration of HC is key target of OUD treatment. Medications used to treat OUD (MOUD) include opioid antagonists (naltrexone) and partial agonists (buprenorphine), which may also impact HC because of their direct impact on opioid receptors implicated in the experience of pleasure and euphoria. The purpose of this study was to examine HC in individuals with OUD treated with buprenorphine or naltrexone. Methods: HC in adults stabilized on MOUD for at least two months was assessed through two self-report instruments: the Snaith-Hamilton Pleasures Scale (SHAPS) and Hedonic Response Survey (HRS). Results: Forty-one participants (M=30 years) with OUD who were treated with buprenorphine (54%) or extended-release naltrexone (46%) and were in concurrent psychosocial treatment completed the surveys. Cross-sectional HC scores were in the normal range after mean 13 months on MOUD, and did not correspond to duration of MOUD treatment. HC was higher for individuals on extended-release naltrexone than buprenorphine on the HRS, but no significant differences emerged on the SHAPS. Conclusions: Sustained treatment for OUD appears to be associated with HC restoration, and concerns about the possible disruption of HC among individuals treated with MOUDs are likely unwarranted.