Examining differences in retention on medication for opioid use disorder: An analysis of Ohio Medicaid data

Zhang, Pengyue; Tossone, Krystel; Ashmead, Robert; Bickert, Tina; Bailey, Emelie; Doogan, Nathan J.; Mack, Aimee; Schmidt, S.; Bonny, Andrea E.

doi:10.1016/j.jsat.2021.108686

Cited by 11 publications

(16 citation statements)

References 26 publications

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“…This scoping review identified 18 studies (Figure 1) evaluating important health outcomes among patients with OUD and ADHD within addiction treatment programs. 6,9,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] The sample size of the included studies ranged from 12 to 81 752 patients. 6,9,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] The follow-up period of longitudinal studies ranged from 12 weeks to 30 years.…”

Section: Resultsmentioning

confidence: 99%

“…6,9,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] The sample size of the included studies ranged from 12 to 81 752 patients. 6,9,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] The follow-up period of longitudinal studies ranged from 12 weeks to 30 years. [24][25][26][27][28][29][30][31][32][33][34]38,39 Included in this review were 1 placebo-controlled trial, 24 5 prospective observational studies, 25,…”

Section: Resultsmentioning

confidence: 99%

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Gaps in Evidence-based Treatment of Concurrent Attention Deficit Hyperactivity Disorder and Opioid Use Disorder: A Scoping Review

2022

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Objectives: To describe the effectiveness of medications for the treatment of opioid use disorder (OUD) and attention deficit/hyperactivity disorder (ADHD). Data Sources: Literature search of PubMed, Embase, Web of Science, CINAHL, Medline, PsycINFO, and Google Scholar was performed for studies published from inception to October 25, 2022. Study Selection and Data Extraction: Studies were included if patients were diagnosed with OUD and ADHD and had pharmacotherapy for either condition. Abstracts, commentaries, reviews, case reports, case series, non-English articles, and animal studies were omitted. Data Synthesis: This review found 18 studies. Treatment of ADHD was evaluated for impact on ADHD and OUD outcomes, while treatment of OUD was evaluated for OUD-related outcomes. Outcomes assessed included markers for symptom intensity, adherence, and treatment failure. While results were mixed, treatment of ADHD was largely associated with improvements in ADHD severity and retention in OUD treatment programs. ADHD severity was associated with higher rates of illicit substance abuse and worse OUD-related outcomes. It could not be determined which medications for treatment of OUD should be prioritized. Relevance to Patient Care and Clinical Practice: This review summarized key findings from studies that treated ADHD or OUD among dually diagnosed patients and highlighted methodological considerations for future research. Conclusions: Treatment of ADHD is warranted among patients with OUD and ADHD to improve retention in OUD treatment programs and reduce illicit substance abuse. Pharmacotherapy for the treatment of ADHD or OUD should continue to be determined based on patients' characteristics and the capabilities of the treatment program.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Gaps in Evidence-based Treatment of Concurrent Attention Deficit Hyperactivity Disorder and Opioid Use Disorder: A Scoping Review

2022

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“…Our finding was slightly better, with roughly half of the patients retained after 6 months in treatment. Although a recent Norwegian study found that the retention rate for XR-NTX was non-inferior to BUP [ 4 ], a recent US study showed that among various types of medication for opioid use disorder, NTX had the highest rate of discontinuation [ 19 , 20 ]. In one US study, 52% of patients discontinued treatment after the initial injection of XR-NTX [ 19 ], whereas only 15% in our sample discontinued after the first injection.…”

Section: Discussionmentioning

confidence: 99%

Impact of Impulsivity, Hyperactivity, and Inattention on Discontinuation Rate among Opioid-Dependent Patients Treated with Extended-Release Naltrexone

Karlsson

Vederhus

Clausen

et al. 2022

IJERPH

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Previous studies have indicated elevated levels of impulsivity, hyperactivity, and inattention (IHI) among opioid-dependent patients seeking outpatient treatment with extended-release naltrexone (XR-NTX). This led us to hypothesize that IHI may be associated with a higher discontinuation rate for XR-NTX treatment. In a group of 162 patients with opioid dependence, discontinuation prior to the full 24 weeks of the study period (six injections and attending the study visit at 24 weeks) occurred in 49% of the patients, primarily in the early stage of treatment. IHI above the clinical cut-off on the adult ADHD self-report scale (ASRS) was not associated with a risk of premature discontinuation. This finding was not altered when controlling for socio-demographics, substance, use and mental health severity. Conclusively, high levels of IHI per se is not contradictive for XR-NTX treatment in regard to concern for premature discontinuation.

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“…MOUD also includes naltrexone, an opioid antagonist that has less data supporting its effectiveness in reducing overdose and drug use-related acute care visits compared to agonist therapies [ 11 ]. While methadone may be best for supporting treatment retention [ 12 ], particularly for patients on fentanyl, buprenorphine is uniquely positioned to have broader availability relative to methadone given the regulations around prescribing the latter.…”

Section: Introductionmentioning

confidence: 99%

A Descriptive Study on Opioid Misuse Prevalence and Office-Based Buprenorphine Access in Ohio Prior to the Removal of the Drug Addiction Treatment Act of 2000 Waiver

McKnight¹,

Dong²,

Brook³

et al. 2023

Cureus

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BackgroundMedications for the treatment of opioid use disorder (MOUD) are effective evidence-based strategies to reduce opioid overdose deaths. Strategies to optimize MOUD availability and uptake are needed. ObjectiveWe aim to describe the spatial relationship between the estimated prevalence of opioid misuse and officebased buprenorphine access in the state of Ohio prior to the removal of the Drug Addiction Treatment Act of 2000 (DATA 2000) waiver requirement. MethodsWe conducted a descriptive ecological study of county-level (N=88) opioid misuse prevalence and officebased buprenorphine prescribing access in Ohio in 2018. Counties were categorized into urban (with and without a major metropolitan area) and rural. The county-level prevalence estimates of opioid misuse per 100,000 were derived from integrated abundance modeling. Utilizing data from the Ohio Department of Mental Health and Addiction Services, as well as the state's Physician Drug Monitoring Program (PDMP), buprenorphine access per 100,000 was estimated by the number of patients in each county that could be served by office-based buprenorphine (prescribing capacity) and the number of patients served by officebased buprenorphine (prescribing frequency) for opioid use disorder. The ratios of opioid misuse prevalence to both prescribing capacity and frequency were calculated by county and mapped. ResultsLess than half of the 1,828 waivered providers in the state of Ohio in 2018 were prescribing buprenorphine, and 25% of counties had no buprenorphine access. The median estimated opioid misuse prevalence and buprenorphine prescribing capacity per 100,000 were highest in urban counties, particularly those with a major metropolitan area. Although the median estimated opioid misuse prevalence was lower in rural counties, all counties in the highest quartile of estimated misuse prevalence were rural. In addition, the median buprenorphine prescribing frequency was highest in rural counties.

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Examining differences in retention on medication for opioid use disorder: An analysis of Ohio Medicaid data

Cited by 11 publications

References 26 publications

Gaps in Evidence-based Treatment of Concurrent Attention Deficit Hyperactivity Disorder and Opioid Use Disorder: A Scoping Review

Gaps in Evidence-based Treatment of Concurrent Attention Deficit Hyperactivity Disorder and Opioid Use Disorder: A Scoping Review

Impact of Impulsivity, Hyperactivity, and Inattention on Discontinuation Rate among Opioid-Dependent Patients Treated with Extended-Release Naltrexone

A Descriptive Study on Opioid Misuse Prevalence and Office-Based Buprenorphine Access in Ohio Prior to the Removal of the Drug Addiction Treatment Act of 2000 Waiver

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