@article{ref1,
title="Associations between distinct co-occurring substance use disorders and receipt of medications for opioid use disorder in the Veterans Health Administration",
journal="Journal of addiction medicine",
year="2022",
author="Frost, Madeline C. and Hawkins, Eric J. and Glass, Joseph E. and Hallgren, Kevin A. and Williams, Emily C.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVES: Among people with opioid use disorder (OUD), having a co-occurring substance use disorder (SUD) is associated with lower likelihood of receiving OUD treatment medications (MOUD). However, it is unclear how distinct co-occurring SUDs are associated with MOUD receipt. This study examined associations of distinct co-occurring SUDs with initiation and continuation of MOUD among patients with OUD in the national Veterans Health Administration (VA). <br><br>METHODS: Electronic health record data were extracted for outpatients with OUD who received care August 1, 2016, to July 31, 2017. Analyses were conducted separately among patients without and with prior-year MOUD receipt to examine initiation and continuation, respectively. SUDs were measured using diagnostic codes; MOUD receipt was measured using prescription fills/clinic visits. Adjusted regression models estimated likelihood of following-year MOUD receipt for patients with each co-occurring SUD relative to those without. <br><br>RESULTS: Among 23,990 patients without prior-year MOUD receipt, 12% initiated in the following year. Alcohol use disorder (adjusted incidence rate ratio [aIRR], 0.80; 95% confidence interval [CI], 0.72-0.90) and cannabis use disorder (aIRR, 0.78; 95% CI, 0.70-0.87) were negatively associated with initiation. Among 11,854 patients with prior-year MOUD receipt, 83% continued in the following year. Alcohol use disorder (aIRR, 0.94; 95% CI, 0.91-0.97), amphetamine/other stimulant use disorder (aIRR, 0.94; 95% CI, 0.90-0.99), and cannabis use disorder (aIRR, 0.95; 95% CI, 0.93-0.98) were negatively associated with continuation. <br><br>CONCLUSIONS: In this study of national VA outpatients with OUD, those with certain co-occurring SUDs were less likely to initiate or continue MOUD. Further research is needed to identify barriers related to specific co-occurring SUDs.<p /> <p>Language: en</p>",
language="en",
issn="1932-0620",
doi="10.1097/ADM.0000000000001095",
url="http://dx.doi.org/10.1097/ADM.0000000000001095"
}