{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T12:00:49Z","timestamp":1772539249943,"version":"3.50.1"},"reference-count":39,"publisher":"BMJ","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2013,2,22]]},"published-print":{"date-parts":[[2013]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To prospectively assess if opiate antagonist treatment or the opiate-free status could reverse opiate-related vasculopathy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Longitudinal Open Observational, Serial \u2018N of One\u2019, over 6.5\u2005years under various treatment conditions: opiate dependence, naltrexone and opiate-free.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Primary care, Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>20 opiate-dependent patients (16 males: 16 cases of buprenorphine 4.11\u00b11.17\u2005mg, two of methadone 57.5\u00b112.5\u2005mg and two of heroin 0.75\u00b10.25\u2005g).<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>Studies of central arterial stiffness and vascular reference age (RA) were performed longitudinally by SphygmoCor Pulse Wave Analysis (AtCor, Sydney).<\/jats:p><\/jats:sec><jats:sec><jats:title>Primary outcomes<\/jats:title><jats:p>Primary outcome was vascular age and arterial stiffness accrual under different treatment conditions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean chronological age (CA) was 33.62\u00b12.03\u2005years. The opiate-free condition was associated with a lower apparent vascular age both in itself (males: p=0.0402 and females: p=0.0360) and in interaction with time (males: p=0.0001 and females: p=0.0004), and confirmed with other measures of arterial stiffness. The mean modelled RA was 38.82, 37.73 and 35.05\u2005years in the opiate, naltrexone and opiate-free conditions, respectively. The opiate-free condition was superior to opiate agonism after full multivariate adjustment (p=0.0131), with modelled RA\/CA of 1.0173, 0.9563 and 0.8985 (reductions of 6.1% and 11.9%, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Data demonstrate that opiate-free status improves vascular age and arterial stiffness in previous chronic opiate users. 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