1. Client and program-level factors associated with planned use of medications for opioid use disorder in specialty substance use treatment programs: Evidence from linked administrative data and survey data.
- Author
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Feder KA, Li Y, Burke KN, Byrne L, Desai IK, Saloner B, and Krawczyk N
- Subjects
- Humans, Adult, Male, Female, Middle Aged, New Jersey, Surveys and Questionnaires, Analgesics, Opioid therapeutic use, Young Adult, Substance Abuse Treatment Centers statistics & numerical data, Opioid-Related Disorders drug therapy, Buprenorphine therapeutic use, Opiate Substitution Treatment statistics & numerical data
- Abstract
Background: Most patients in specialty drug treatment programs that are not federally licensed Opioid Treatment Programs (OTPs) programs do not receive medications for opioid use disorder (MOUD)., Methods: We linked results from a survey of non-OTP treatment program directors in New Jersey (n = 81) to statewide administrative records of admissions for opioid use to those programs between July 2021-June 2022. Using multi-level regression, we examined the association of three types of factors with planned MOUD use: program survey responses, client-level factors, and program-level client characteristic mix., Results: Of 9583 opioid treatment admissions in non-OTP settings, 41 % included treatment plans involving MOUD. Programs where directors reported staff concerns about buprenorphine's efficacy or diversion had a lower proportion of clients with planned MOUD, as did programs reporting too little physical space to prescribe. Being self-referred to treatment, unemployed and not looking for work, aged 30-49, heroin use (vs. prescription opioid use), and stimulant use in addition to opioids, were positively associated with planned MOUD; while non-Medicaid insurance, and Black and Hispanic race/ethnicity, were negatively associated with planned MOUD. Clients were more likely to have planned MOUD if their programs had a higher proportion of clients aged 30 or older, heroin as primary "drug of abuse," stimulant use, and not working but actively looking for work., Conclusion: Findings suggest addressing program staff attitudes toward buprenorphine could help increase planned MOUD. There is also a need to improve access for clients with non-Medicaid insurance, address within-program race and ethnic disparities, and address employment-related barriers to medication., Competing Interests: Declaration of competing interest This research was supported by a grant from Bloomberg Philanthropies. The authors have no interests to declare., (Copyright © 2024 Elsevier Inc. All rights reserved.)
- Published
- 2025
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