Carrie M Mintz1, Ned J Presnall2, Kevin Y Xu3, Sarah M Hartz3, John M Sahrmann4, Laura J Bierut3, Richard A Grucza5. 1. Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Ave, Campus Box 8134, St. Louis, MO, 63110, United States. Electronic address: mintzc@wustl.edu. 2. Department of Social Work, Washington University, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, United States. 3. Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Ave, Campus Box 8134, St. Louis, MO, 63110, United States. 4. Department of Medicine, Division of Infectious Diseases, Washington University School of Medicine, 4990 Children's Place, St. Louis, MO, 63110, United States. 5. Departments of Family and Community Medicine and Health and Outcomes Research, St. Louis University, 1008 South Spring, SLUCare Academic Pavilion, 3rd Floor, St. Louis, MO, 63110, United States.
Abstract
BACKGROUND AND AIMS: Persons with opioid use disorder (OUD) and co-occurring alcohol use disorder (AUD) are understudied. We identified whether co-occurring AUD was associated with OUD treatment type, compared associations between treatment type and six-month treatment retention and determined whether co-occurring AUD moderated these relationships. METHODS: We used an observational cohort study design to analyze insurance claims data from 2011 to 2016 from persons aged 12-64 with an opioid abuse or opioid dependence diagnosis and OUD treatment claim. Our unit of analysis was the treatment episode; we used logistic regression for analyses. RESULTS: Of 211,047 treatment episodes analyzed, 14 % had co-occurring alcohol abuse or dependence diagnoses. Among persons with opioid dependence, persons with co-occurring alcohol dependence were 25 % less likely to receive medication treatment relative to those without AUD. Further, alcohol dependence was associated with decreased likelihood of treatment with buprenorphine (AOR 0.47, 95 % CI 0.44-0.49) or methadone (AOR 0.31, 95 % CI 0.28-0.35) and increased likelihood of treatment with extended-release (AOR 1.36, 95 % CI 1.21-1.54) or oral (AOR 1.73, 95 % CI 1.57-1.90) naltrexone relative to psychosocial treatment. Buprenorphine and methadone were associated with highest retention prevalence regardless of OUD or AUD severity. Co-occurring alcohol abuse or dependence did not meaningfully change retention prevalence associated with buprenorphine or methadone. Co-occurring AUD was not associated with improved retention among persons receiving either formulation of naltrexone. CONCLUSIONS: Buprenorphine and methadone are associated with relatively high likelihood of treatment retention among persons opioid and alcohol dependence, but are disproportionately under-prescribed.
BACKGROUND AND AIMS: Persons with opioid use disorder (OUD) and co-occurring alcohol use disorder (AUD) are understudied. We identified whether co-occurring AUD was associated with OUD treatment type, compared associations between treatment type and six-month treatment retention and determined whether co-occurring AUD moderated these relationships. METHODS: We used an observational cohort study design to analyze insurance claims data from 2011 to 2016 from persons aged 12-64 with an opioid abuse or opioid dependence diagnosis and OUD treatment claim. Our unit of analysis was the treatment episode; we used logistic regression for analyses. RESULTS: Of 211,047 treatment episodes analyzed, 14 % had co-occurring alcohol abuse or dependence diagnoses. Among persons with opioid dependence, persons with co-occurring alcohol dependence were 25 % less likely to receive medication treatment relative to those without AUD. Further, alcohol dependence was associated with decreased likelihood of treatment with buprenorphine (AOR 0.47, 95 % CI 0.44-0.49) or methadone (AOR 0.31, 95 % CI 0.28-0.35) and increased likelihood of treatment with extended-release (AOR 1.36, 95 % CI 1.21-1.54) or oral (AOR 1.73, 95 % CI 1.57-1.90) naltrexone relative to psychosocial treatment. Buprenorphine and methadone were associated with highest retention prevalence regardless of OUD or AUD severity. Co-occurring alcohol abuse or dependence did not meaningfully change retention prevalence associated with buprenorphine or methadone. Co-occurring AUD was not associated with improved retention among persons receiving either formulation of naltrexone. CONCLUSIONS: Buprenorphine and methadone are associated with relatively high likelihood of treatment retention among persons opioid and alcohol dependence, but are disproportionately under-prescribed.
Authors: Sarah E Wakeman; Marc R Larochelle; Omid Ameli; Christine E Chaisson; Jeffrey Thomas McPheeters; William H Crown; Francisca Azocar; Darshak M Sanghavi Journal: JAMA Netw Open Date: 2020-02-05
Authors: Peter D Friedmann; Donna Wilson; Edward V Nunes; Randall Hoskinson; Joshua D Lee; Michael Gordon; Sean M Murphy; Richard J Bonnie; Donna T Chen; Tamara Y Boney; Charles P O'Brien Journal: J Subst Abuse Treat Date: 2017-02-22
Authors: Karolina M Bogdanowicz; Robert Stewart; Matthew Broadbent; Stephani L Hatch; Matthew Hotopf; John Strang; Richard D Hayes Journal: Drug Alcohol Depend Date: 2015-01-03 Impact factor: 4.492
Authors: Carrie M Mintz; Kevin Y Xu; Ned J Presnall; Sarah M Hartz; Frances R Levin; Jeffrey F Scherrer; Laura J Bierut; Richard A Grucza Journal: JAMA Netw Open Date: 2022-05-02