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The Journal of Behavioral Health Services & Research

Erschienen in:

13.06.2023

Outcomes Associated with Treatment with and Without Medications for Opioid Use Disorder

verfasst von: Ryan Mutter, PhD, Donna Spencer, PhD, Jeffrey McPheeters, BA

Erschienen in: The Journal of Behavioral Health Services & Research | Ausgabe 4/2023

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Abstract

There is limited research on outcomes for patients who start treatment for opioid use disorder (OUD) with only psychosocial treatment compared to those who initiate treatment with either medications for OUD (MOUD) or the combination of psychosocial treatment and MOUD. Cox proportional hazards regression was used on a database of individuals with commercial health insurance or Medicare Advantage to estimate the associations of treatment type with opioid overdose and self-harm (separately). Logistic regression was used to estimate the association of treatment type with prescription opioid fill following treatment initiation. Relative to patients who initiated treatment with only psychosocial treatment, patients who also initiated treatment with MOUD had lower risk of having an overdose inpatient or emergency department (ED) encounter, a self-harm inpatient or ED encounter, and a prescription opioid filled following treatment initiation. Starting treatment with MOUD was associated with better patient outcomes than initiating treatment with only psychosocial treatment.

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Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: Results from the 2020 National Survey on Drug Use and Health. Center for Behavioral Health Statistics and Quality. Publication No. PEP21-07-01-003, October, 2021. Available at https://www.samhsa.gov/data/sites/default/files/reports/rpt35325/NSDUHFFRPDFWHTMLFiles2020/2020NSDUHFFR1PDFW102121.pdf. Accessed 02 April, 2023.

Saloner B, Barry CL. Ending the opioid epidemic requires a historic investment in medication-assisted treatment. Journal of Policy Analysis and Management 2018; 37(2):431–438. Available at https://doi.org/10.1002/pam.22047. Accessed 02 April, 2023.

Kampman K, Jarvis M. American Society of Addiction Medicine (ASAM) national practice guideline for the use of medications in the treatment of addiction involving opioid use. Journal of Addiction Medicine 2015; 9(5):358–367. Available at https://doi.org/10.1097/adm.0000000000000166. Accessed 02 April, 2023.

Mutter R, Spencer D, McPheeters J. Factors associated with initial treatment choice, engagement, and discontinuation for patients with opioid use disorder. Psychiatric Services 2022; 73(6):604–612. Available at https://doi.org/10.1176/appi.ps.202100239. Accessed 02 April, 2023.

Au VYO, Rosic T, Sanger N, et al. Factors associated with opioid overdose during medication-assisted treatment: How can we identify individuals at risk? Harm Reduction Journal 2021; 18, 71. Available at https://doi.org/10.1186/s12954-021-00521-4. Accessed 02 April, 2023

Morgan JR, Barocas JA, Murphy SM, et al. Comparison of rates of overdose and hospitalization after initiation of medication for opioid use disorder in the inpatient vs outpatient setting. Journal of the American Medical Association Network Open 2020; 3(12):e2029676. Available at http://jamanetwork.com/article.aspx?doi=https://doi.org/10.1001/jamanetworkopen.2020.29676. Accessed 02 April, 2023.

Wakeman S, Larochelle M, Ameli O, et al. Comparative effectiveness of different treatment pathways for opioid use disorder. Journal of the American Medical Association Network Open 2020; 3(2):e1920622. Available at https://doi.org/10.1001/jamanetworkopen.2019.20622. Accessed 02 April, 2023.

Bohnert A, Ilgen M. Understanding links among opioid use, overdose, and suicide. New England Journal of Medicine 2019; 380(1):71–79. Available at https://www.nejm.org/doi/full/https://doi.org/10.1056/NEJMra1802148. Accessed 02 April, 2023.

Oquendo MA, Volkow ND. Suicide: A Silent contributor to opioid-overdose deaths. New England Journal of Medicine 2018; 378(17):1567–1569. Available at https://doi.org/10.1056/nejmp1801417. Accessed 02 April, 2023.

10.

Watts B, Gottlieb D, Riblet N, et al. Association of medication treatment for opioid use disorder with suicide mortality. American Journal of Psychiatry 2022; 179(4):298–304. Available at https://doi.org/10.1176/appi.ajp.2021.21070700. Accessed 02 April, 2023.

11.

Oesterle T, Thusius N, Rummans T, et al. Medication-assisted treatment for opioid-use disorder. Mayo Clinical Proceedings 2019; 94(10):272–286. Available at https://doi.org/10.1016/j.mayocp.2019.03.029. Accessed 02 April, 2023.

12.

Naeger S, Ali M, Mutter R, et al. Prescriptions filled following an opioid-related hospitalization. Psychiatric Services 2016; 67(11):1262–1264. Available at https://doi.org/10.1176/appi.ps.201500538. Accessed 02 April, 2023.

13.

Meinhofer A, Hinde JM, Ali MM. Substance use disorder treatment services for pregnant and postpartum women in residential and outpatient settings. Journal of Substance Abuse Treatment 2020; 110:9–17. Available at https://doi.org/10.1016/2Fj.jsat.2019.12.005. Accessed 02 April, 2023.

14.

Chronic Conditions Data Warehouse (CCW) Condition Categories. Baltimore, MD: Centers for Medicare and Medicaid Services, 2021. Available at https://www2.ccwdata.org/web/guest/condition-categories. Accessed 02 April, 2023.

15.

16.

Rice D, Corace C, Wolfe D, et al. Evaluating comparative effectiveness of psychosocial interventions adjunctive to opioid agonist therapy for opioid use disorder: A systematic review with network meta-analyses. PLOS One 2020; 15(12):e0244401. Available at https://doi.org/10.1371/journal.pone.0244401. Accessed 02 April, 2023.

17.

Jakubowski A, Fox A. Defining low-threshold buprenorphine treatment. Journal of Addiction Medicine 2020; 14(2):95–98. Available at https://doi.org/10.1097/adm.0000000000000555. Accessed 02 April, 2023.

18.

Palumbo S, Adamson K, Krishnamurthy S, et al. Assessment of probable opioid use disorder using electronic health record documentation. Journal of the American Medical Association Network Open 2020; 3:e2015909. Available at http://jamanetwork.com/article.aspx?doi=https://doi.org/10.1001/jamanetworkopen.2020.15909. Accessed 02 April, 2023.

19.

Lembke A, Humphreys K., Newmark J. Weighing the risks and benefits of chronic opioid therapy. American Family Physician 2016; 93:982–990. Available at https://www.aafp.org/pubs/afp/issues/2016/0615/p982.html. Accessed 02 April, 2023.

20.

Congressional Budget Office. The opioid crisis and recent federal policy responses. 2022. Available at https://www.cbo.gov/system/files/2022-09/58221-opioid-crisis.pdf. Accessed 02 April, 2023.

21.

Substance Abuse and Mental Health Services Administration. TIP 63: Medications for opioid use disorder. Center for Behavioral Health Statistics and Quality. Publication No. PEP21–02–01–002, July, 2021. Available at https://store.samhsa.gov/sites/default/files/pep21-02-01-002.pdf. Accessed 02 April, 2023.

22.

Mackey K, Veazie S, Anderson J, et al. Barriers and facilitators to the use of medications for opioid use disorder: A rapid review. Journal of General Internal Medicine 2020; 35(Suppl 3):954–963. Available at https://doi.org/10.1007/s11606-020-06257-4. Accessed 02 April, 2023.

Titel: Outcomes Associated with Treatment with and Without Medications for Opioid Use Disorder
verfasst von: Ryan Mutter, PhD
Donna Spencer, PhD
Jeffrey McPheeters, BA
Publikationsdatum: 13.06.2023
Verlag: Springer US
Erschienen in: The Journal of Behavioral Health Services & Research / Ausgabe 4/2023
Print ISSN: 1094-3412
Elektronische ISSN: 1556-3308
DOI: https://doi.org/10.1007/s11414-023-09841-8

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Outcomes Associated with Treatment with and Without Medications for Opioid Use Disorder

Abstract

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