Associations Between Polysubstance Use Patterns and Receipt of Medications for Opioid Use Disorder Among Adults in Treatment for Opioid Use Disorder.

J Addict Med

Health, Homelessness, and Criminal Justice Lab, Hennepin Healthcare Research Institute, Minneapolis, MN (BRF, TNAW), Division of Addiction Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis, MN (GB, BG), University of Minnesota Medical School, Minneapolis, MN (RDS), Division of General Internal Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis, MN (TNAW).

Published: April 2021

Objective: To examine trends in polysubstance use among adults in treatment for opioid use disorder (OUD) and estimate associations between polysubstance use patterns and receipt of medications for OUD (MOUD).

Methods: We conducted a cross-sectional longitudinal analysis of treatment admissions for opioid use from 1992 to 2017 using the Treatment Episodes Data Set-Admissions (N = 9,440,157). We used multiple logistic regression to examine co-use patterns and estimate associations between receipt of MOUD and polysubstance use categories (opioid only, any methamphetamine, any cocaine, any alcohol, any benzodiazepine).

Results: Between 1992 and 2017, treatment admissions involving opioid/cocaine (-17.2 percentage points [PP]) and opioid/alcohol co-use (-12.5 PP) decreased while opioid/methamphetamine (10.1 PP) and opioid/benzodiazepine co-use (5.6 PP) increased. In 2016 to 2017, receipt of medications for OUD was significantly higher for those who used opioids only (38.5%; 95% confidence interval [CI] 38.4-38.6) compared with individuals who used opioids with cocaine (35.7%; 95% CI 35.6-35.9), methamphetamine (23.9%; 95% CI 23.7-24.2), alcohol (25.0%; 95% CI 24.8-25.2), or benzodiazepines (34.6%; 95% CI 34.3-34.9). If those who co-used opioids with other substances received MOUD at the same rate as those who used opioids only, 47,400 additional people would have received MOUD between 2016 and 2017.

Conclusions: Opioid/methamphetamine and opioid/benzodiazepine increased substantially between 1992 and 2017. Co-use of other substances with opioids was associated with significantly lower receipt of MOUD. Treatment facilities should increase access to MOUD for individuals who co-use opioids with other substances. This change would extend evidence-based treatment to thousands of individuals and save lives.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7969153PMC
http://dx.doi.org/10.1097/ADM.0000000000000726DOI Listing

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