Journal of substance use and addiction treatment最新文献

{"title":"A participatory photovoice investigation of community assets, barriers, and opportunities to curb the opioid epidemic","authors":"P. Balvanz ,&nbsp;R.G. Olvera ,&nbsp;M. Booty ,&nbsp;J. McSwiggan ,&nbsp;C. Damato-MacPherson ,&nbsp;S. Ellison ,&nbsp;A. Farmer ,&nbsp;K. Klingler ,&nbsp;A. Kuntz ,&nbsp;N. Lewis ,&nbsp;C.B. Oser ,&nbsp;L. Sprague Martinez ,&nbsp;S. Stitzer ,&nbsp;H. Surratt ,&nbsp;O. Yamoah ,&nbsp;A. Berkshire ,&nbsp;T. Carter ,&nbsp;K. Campbell ,&nbsp;S. Dynes ,&nbsp;B. Gealy ,&nbsp;M. McGladrey","doi":"10.1016/j.josat.2025.209741","DOIUrl":"10.1016/j.josat.2025.209741","url":null,"abstract":"<div><div>The opioid epidemic remains an entrenched issue in communities due to its multiple and interrelated risk factors. As part of the HEALing Communities Study, we recruited people with lived experience of substance use disorder and practitioners in the field to participate in multi-session Photovoice projects to contextualize the opioid use landscape in their respective communities. Photovoice combines photography and group discussion to explore concerns and strengths in a community. Researchers facilitated 21 Photovoice projects (<em>N</em> = 127 participants) across 19 communities in the Kentucky, Massachusetts, and Ohio HCS sites. We performed template analysis on the Photovoice discussion transcripts to develop a codebook organized by the Socioecological Model domains, analyzed the transcripts, and developed themes reflecting barriers to and facilitators of responding to the opioid crisis at each socioecological level. We engaged a subset of participants across sites to prioritize these results by importance in addressing the opioid epidemic in their communities. A comprehensive list of themes from the 64 photo discussion sessions are presented, with a focus on the themes prioritized by participants that included the importance of peer recovery support, diverse and collaborative services, advocacy and education to diminish stigma, and the need for resources to address social determinants of health such as housing, recreation, and transportation. Our findings offer key insights to address the opioid crisis within communities. Using participatory methods such as Photovoice to engage experts with lived experience and/or direct work with substance use disorder can help identify gaps and opportunities for potential solutions.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"176 ","pages":"Article 209741"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144534119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing stigma in primary care toward people who use drugs: A pilot study exploring the promise and limits of stigma training","authors":"Erin Fanning Madden ,&nbsp;Fares Qeadan ,&nbsp;Felicia Frabis ,&nbsp;Jonathan Cohn ,&nbsp;William Barbeau ,&nbsp;Mark K. Greenwald","doi":"10.1016/j.josat.2025.209748","DOIUrl":"10.1016/j.josat.2025.209748","url":null,"abstract":"<div><h3>Background</h3><div>Primary care can improve health for people who use drugs (PWUD), but stigma among healthcare professionals impedes patient engagement. Past research suggests training reduces stigmatizing professional attitudes, but effects on other aspects of healthcare stigma are largely unknown. This pilot study tests whether stigma reduction training changes three stigma processes toward PWUD in primary care: attitudes, intentions to provide care, and workplace culture.</div></div><div><h3>Methods</h3><div>The study delivered a two-hour substance use stigma training to clinical (e.g., physicians) and non-clinical (e.g., reception staff) primary care professionals in Michigan. Pre- and post-training survey data were collected, and a one-hour qualitative focus group was conducted with a subset of respondents. Cohen's <em>d</em> and paired <em>t</em>-tests assessed changes in stigma. The study analyzed qualitative data using thematic analysis.</div></div><div><h3>Results</h3><div>Fifty-one professionals completed surveys, and five professionals participated in the focus group. Training reduced stigmatizing attitudes toward PWUD (e.g., improvement in the Medical Condition Regard Scale <em>d</em> = 0.499, <em>p</em> = 0.007), but did not change intention to enact stigma or workplace culture. Qualitative data suggested training promoted empathy toward PWUD and explained best practices, but training also revealed gaps between evidence and current clinic practices. Participants noted that external factors that training does not alter, e.g. controlled substance prescribing regulations, may disincentivize professional engagement with PWUD.</div></div><div><h3>Conclusions</h3><div>This pilot study explores the promise and limits of training for altering professional stigma toward PWUD in primary care. Although training readily reduces attitudinal forms of stigma, other interventions are likely needed to reduce stigmatizing professional behaviors and primary care environments.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"176 ","pages":"Article 209748"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Treating me like a criminal\": A qualitative study of birthing parents' perspectives on racism and biases in newborn drug testing for substance exposure during pregnancy.","authors":"Jamie Huizinga, Lauren Oshman, Regina Onishchenko, Madgean Joassaint, Emily Madlambayan, Murphy Van Sparrentak, Kate McCabe, Courtney Townsel, Christopher J Frank, P Paul Chandanabhumma, Justine Wu","doi":"10.1016/j.josat.2025.209745","DOIUrl":"https://doi.org/10.1016/j.josat.2025.209745","url":null,"abstract":"<p><strong>Introduction: </strong>Black birthing people are more likely to have their newborns undergo testing for drug exposure with subsequent reporting to Child Protective Services (CPS) and termination of parental rights compared to White birthing people. The study aim was to describe the experiences of people who gave birth regarding newborn drug testing (NDT) and explore the impact of racism and other biases. A secondary aim was to elicit participant recommendations for policy changes to address racial inequities in NDT and CPS reporting.</p><p><strong>Methods: </strong>This qualitative study is the third and last phase of an explanatory sequential mixed methods study (quantitative phase followed by qualitative phase). We conducted semi-structured interviews with 15 participants who had given birth within the last 12 months at a single academic hospital in the midwestern United States. We purposefully sampled racial minorities and those who went through NDT to ensure their perspectives were represented. Our interview guide, data collection, and reflexive thematic interpretation were informed by the Public Health Critical Race Praxis and the Levels of Racism framework. A six member Participatory Council and two external antiracist research consultants provided guidance on study activities and data interpretation.</p><p><strong>Results: </strong>We identified four major themes: 1) being honest about substance use with healthcare providers can lead to punishment and CPS reporting; 2) historical and contemporary racism perpetuate negative stereotypes about Black patients, contributing to racial disparities in NDT; 3) the medical and legal risks of recreational cannabis use in pregnancy were not clearly explained by healthcare providers; 4) participants advocated for non-punitive, respectful, and early care for substance use during pregnancy, including a clear explanation of local NDT and CPS reporting policies.</p><p><strong>Conclusions: </strong>Our findings highlight the need for policy changes to decriminalize newborn drug testing and address systematic racism and bias against Black parents throughout the process. Participants identified a need to improve early access to non-judgmental substance use counseling and treatment that includes clear and consistent guidance about NDT and in particular, the health and legal implications of cannabis use during pregnancy.</p>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":" ","pages":"209745"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of telehealth, in-person, and hybrid care modalities on buprenorphine discontinuation among patients with opioid use disorder: A retrospective cohort study on commercially insured individuals","authors":"Jabed Al Faysal ,&nbsp;Md. Noor-E-Alam ,&nbsp;Gary J. Young ,&nbsp;Mohammad Yaseliani ,&nbsp;Amie J. Goodin ,&nbsp;Md Mahmudul Hasan","doi":"10.1016/j.josat.2025.209749","DOIUrl":"10.1016/j.josat.2025.209749","url":null,"abstract":"<div><h3>Introduction</h3><div>Opioid use disorder (OUD) is a leading cause of mortality in the United States. Buprenorphine is an effective treatment for OUD, but its benefits rely on sustained treatment retention. The expansion of telehealth and hybrid care models, particularly during the COVID-19 pandemic, provides an opportunity to improve retention. However, the comparative effectiveness of these care modalities on buprenorphine discontinuation across different treatment phases remains unclear.</div></div><div><h3>Methods</h3><div>This retrospective cohort study utilized IBM MarketScan Commercial Claims data from September 2019 to December 2022. The study included insured individuals aged ≥18 years diagnosed with OUD who initiated buprenorphine treatment between March 23, 2020, and December 31, 2021. Patients were stratified into telehealth, in-person, and hybrid care (initiating treatment via telehealth and receiving 51–75 % of visits in-person) groups. The primary outcome was buprenorphine discontinuation, defined as a gap of ≥30 days in prescription fills/refills during the 12-month follow-up. Discontinuation was assessed as two separate binary outcomes: (1) early-phase discontinuation, defined as a gap of ≥30 days within the first 3 months of treatment, and (2) late-phase discontinuation, defined as a gap of ≥30 days between months 4 and 12 among those who remained on treatment through the initial 3 months. Multivariable logistic regression models adjusted for covariates were applied for each outcome, and propensity score matching (PSM) was employed to minimize confounding.</div></div><div><h3>Results</h3><div>Among 10,783 patients (mean age 43.25 ± 12.62 years; 49.52 % female), those treated via telehealth were significantly less likely to discontinue buprenorphine during the early treatment phase compared to patients in both in-person and hybrid care groups (OR: 0.83, 95 % CI: 0.75–0.92). During the late treatment phase, patients receiving hybrid care had significantly lower odds of discontinuation compared to those receiving either telehealth or in-person care (OR: 0.73, 95 % CI: 0.62–0.86). These findings were consistent in both unmatched and matched analyses.</div></div><div><h3>Conclusions</h3><div>Telehealth was associated with improved early retention in buprenorphine treatment, while hybrid care models were more effective for long-term retention. The findings suggest that a phased approach, where telehealth is leveraged for treatment initiation and early retention, and when the patient continues via a hybrid model for long-term care, may optimize buprenorphine treatment outcomes.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"176 ","pages":"Article 209749"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential impact of peer support service on SUD treatment engagement following ED visits among Kentucky medicaid beneficiaries","authors":"Xiaoni Zhang ,&nbsp;Valerie Hardcastle ,&nbsp;Thuong Ho ,&nbsp;Gary Ozanich","doi":"10.1016/j.josat.2025.209746","DOIUrl":"10.1016/j.josat.2025.209746","url":null,"abstract":"<div><h3>Background</h3><div>Research indicates that peer support has a positive impact on patients with substance use disorders (SUD). Despite promising findings, integrating peer support into SUD treatment remains limited, particularly during the critical transition period between emergency department (ED) discharge and treatment initiation. This study examines the effectiveness of Kentucky-certified Peer Support Specialists (PSS) during that period within a Medicaid population.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of beneficiaries with SUD who initiated treatment following an ED visit using Kentucky Medicaid claims data from July 1, 2022, to June 30, 2023. We assessed prior health conditions using 12-month lookback period (July 2021–June 2022). We then compared monthly engagement outcomes between beneficiaries who received PSS and those who did not.</div></div><div><h3>Results</h3><div>PSS was consistently associated with higher odds of treatment engagement across six months. In unadjusted logistic regression models, odds ratios (ORs) for the PSS group ranged from 1.75 (95 % CI: 1.45–2.09) to 4.17 (95 % CI: 3.53–4.91). Adjusted models accounting for age, sex, geographic location, and health conditions yielded ORs between 1.63 (95 % CI: 1.35–1.95) and 3.84 (95 % CI: 3.23–4.55).</div><div>Subgroup analysis by sex showed that females receiving PSS had ORs ranging from 1.50 (95 % CI: 1.10–2.05) to 3.77 (95 % CI: 2.80–5.07), while males showed ORs from 1.70 (95 % CI: 1.43–2.14) to 4.22 (95 % CI: 3.43–5.22). Among those with one health condition, PSS effects ranged from Month 1 (OR = 1.41, 95 % CI: 1.03–1.95) to a peak in Month 2 (OR = 4.51, 95 % CI: 3.32–6.13). For those with two conditions, effects increased from Month 1 (OR = 1.76, 95 % CI: 1.33–2.34) to a peak in Month 3 (OR = 4.21, 95 % CI: 3.25–5.45). In the group with three or more conditions, ORs started at 2.49 (95 % CI: 1.43–4.32) and remained high through Month 6 (OR = 3.46, 95 % CI: 2.18–5.48).</div></div><div><h3>Conclusions</h3><div>Peer support services are associated with the increased likelihood of SUD engagement in Kentucky Medicaid enrollees. Subgroup findings by gender and health complexity highlight its broad effectiveness. These results support expanding access to peer support in Medicaid policy and practice.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"176 ","pages":"Article 209746"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“All it's gonna tell you is if it has fentanyl or not:” Perceptions of fentanyl and drug checking among first responders and people who use drugs","authors":"Brenda Y. Goh ,&nbsp;Emily C. Williams ,&nbsp;Courteney Wettemann ,&nbsp;Callan E. Fockele ,&nbsp;Tessa Frohe ,&nbsp;Grover Williams ,&nbsp;Nathan Holland ,&nbsp;Rachel E. Rourke ,&nbsp;Robert Pitcher ,&nbsp;Thea Oliphant-Wells ,&nbsp;Jenna van Draanen","doi":"10.1016/j.josat.2025.209747","DOIUrl":"10.1016/j.josat.2025.209747","url":null,"abstract":"<div><h3>Introduction</h3><div>Fentanyl contamination in the unregulated drug supply contributes to high rates of opioid overdose among people who use drugs (PWUD). Drug checking is a harm reduction strategy that provides PWUD with information about the contents of their substances. Although drug checking has broad utility, this study focused specifically on drug checking to test for fentanyl, with a particular emphasis on fentanyl test strips (FTS) and point-of-care testing at community service organizations. This study assessed first responders and PWUDs' perceptions of fentanyl, drug checking, and associated implementation suggestions.</div></div><div><h3>Methods</h3><div>The risk environment framework and community-engaged methods guided the study. First responders and PWUD were recruited using convenience sampling from first responder agencies and community service locations, respectively, in King County, WA. The study conducted semi-structured interviews with first responders (<em>n</em> = 32; law enforcement officers, paramedics, emergency medical services, firefighters, etc.) and PWUD (<em>n</em> = 13) until data saturation. A group of academically trained and peer-based researchers with lived experiences of substance use analyzed the data using a thematic analysis approach.</div></div><div><h3>Results</h3><div>First responders and PWUD discussed the fentanyl-saturated drug use landscape and the amplification of PWUDs' overdose risk. Preferences for fentanyl among PWUD varied, ranging from a preference for it, to willingness to use it, to strong aversion. Most first responders expressed concerns about post-overdose FTS distribution, viewing it as ineffective in promoting safer use behaviors and inconsistent with their workflow and provider role. People who use fentanyl perceived drug checking to be of low relevance due to fentanyl's ubiquity, while PWUD who were trying to avoid it cited numerous barriers, including low availability, trust in sellers, limitations of FTS, and lack of information or connections.</div></div><div><h3>Conclusions</h3><div>The study found low support for drug checking for fentanyl and first responders' distribution of FTS. Drug checking may have the most utility for PWUD who were trying to avoid fentanyl; however, its potential benefits may not be fully realized until structural barriers to access and use are addressed. Caution should be exercised to not promote drug checking as a universal tool and place the onus of addressing fentanyl contamination on PWUD.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"176 ","pages":"Article 209747"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a primary care-based Medication for Opioid Use Disorder (MOUD) program in a fully-integrated federally qualified health center","authors":"Karen Howard ,&nbsp;Pamela Stover ,&nbsp;Andrew Suchocki","doi":"10.1016/j.josat.2025.209744","DOIUrl":"10.1016/j.josat.2025.209744","url":null,"abstract":"<div><h3>Introduction</h3><div>Clackamas Health Centers (CHC), a public sector Federally Qualified Health Center in Oregon, has been providing medication for opioid use disorder (MOUD) in a low-barrier, harm reduction model for over a decade. CHC also provides a unique pathway for criminal justice-involved patients to receive MOUD treatment. CHC's primary care-based treatment program has seen substantial growth since it began; however, a comprehensive review has never been completed.</div></div><div><h3>Methods</h3><div>A mixed-methodology program evaluation was undertaken to determine if the CHC MOUD program is providing effective low-barrier care. Outcomes for this evaluation included retention rate, opioid-free urine drug screen (UDS) results, patient and provider satisfaction, and patient improvement in quality of life.</div></div><div><h3>Results</h3><div>Data collected from July 1, 2022 to December 31, 2022 showed a 6-month retention rate of 85 % (<em>N</em> = 186). Urine drug screens were opioid-negative for 91 % of samples examined (<em>N</em> = 222). Patients reported positive lifestyle changes after receiving MOUD treatment, demonstrated by Treatment Effectiveness Assessment scores. Medical providers surveyed (<em>N</em> = 9) felt satisfied in their work treating patients with opioid use disorder and patients (<em>N</em> = 24) reported satisfaction with the care they were receiving in the MOUD program.</div></div><div><h3>Conclusion</h3><div>While data on primary care-based MOUD models is sparse, this evaluation has shown similar or better results than those noted in other studies on outcomes such as retention and urine drug screen results. These data can help demonstrate the effectiveness of fully-integrated MOUD programs in primary care, as well as establishing a baseline for treatment outcomes and future program evaluation.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"176 ","pages":"Article 209744"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of craving on retention and treatment switching under buprenorphine-naloxone and methadone models of care for non-heroin opioid use disorder: Exploratory analyses from a pragmatic, randomized controlled trial","authors":"Christina McAnulty ,&nbsp;Gabriel Bastien ,&nbsp;Anita Abboud ,&nbsp;Arash Bahremand ,&nbsp;Omar Ledjiar ,&nbsp;M. Eugenia Socias ,&nbsp;Bernard Le Foll ,&nbsp;Louis-Christophe Juteau ,&nbsp;Didier Jutras-Aswad ,&nbsp;for the OPTIMA Research Group within the Canadian Research Initiative in Substance Misuse","doi":"10.1016/j.josat.2025.209743","DOIUrl":"10.1016/j.josat.2025.209743","url":null,"abstract":"<div><h3>Introduction</h3><div>Though opioid agonist therapies are the mainstay of treatment for opioid use disorder, treatment retention remains suboptimal. Improved prediction of who will remain in treatment could lead to improved treatment outcomes. Whether craving predicts reduced retention in treatment remains debated. We performed analyses to determine whether craving predicted treatment attrition or treatment switching in people with non-heroin opioid use disorder initiating opioid agonist therapy.</div></div><div><h3>Methods</h3><div>Our data came from the OPTIMA trial - a pan-Canadian, pragmatic, open-label, randomized controlled trial that compared a flexible, early take-home buprenorphine/naloxone model of care (<em>n</em> = 137) to standard treatment with methadone (<em>n</em> = 132) for non-heroin opioid use disorder over a period of 24 weeks. We performed Cox proportional hazards regression to conduct survival analyses of time (days) to treatment attrition, and time to switch to another treatment, with craving as a time-varying covariate, controlling for assigned treatment group, lifetime history of heroin use and province. Craving was measured at baseline, week 2, 6, 10, 14, 18, 22 using the Brief Substance Craving Scale.</div></div><div><h3>Results</h3><div>We found that craving predicted both treatment drop out and treatment switching. A 1-point increase in craving was associated with a 15.3 % increase of risk of dropping out of the study (HR = 1.153, 95 % CI = 1.065 to 1.248, <em>p</em> &lt; 0.001) and with a 11.5 % increase of risk of switching treatment (HR = 1.115, 95 % CI = 1.016 to 1.225, <em>p</em> = 0.022).</div></div><div><h3>Conclusions</h3><div>Craving predicted both treatment attrition and treatment switching in people receiving buprenorphine/naloxone or methadone models of care for non-heroin opioid use disorder. These findings highlight the importance of targeting and better addressing craving during treatment with opioid agonist therapies.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"176 ","pages":"Article 209743"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TOC (update)","authors":"","doi":"10.1016/S2949-8759(25)00113-4","DOIUrl":"10.1016/S2949-8759(25)00113-4","url":null,"abstract":"","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"175 ","pages":"Article 209734"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between buprenorphine adherence for opioid use disorder and clinical events and healthcare spending among older patients","authors":"Olajumoke A. Olateju ,&nbsp;Mina Shrestha ,&nbsp;J. Douglas Thornton","doi":"10.1016/j.josat.2025.209740","DOIUrl":"10.1016/j.josat.2025.209740","url":null,"abstract":"<div><h3>Background</h3><div>Buprenorphine adherence in older adults with opioid use disorder (OUD) remains underexplored. This study investigated the associations between buprenorphine adherence and risks of opioid overdose, hospitalization, and healthcare spending among older adults to help inform practice and policy.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, we utilized the Merative MarketScan® Database (2017–2019) to identify Medicare Advantage enrollees with OUD who initiated buprenorphine and were retrospectively followed for 180 days. We classified patients as adherent (Proportion of Days Covered ≥0.80) or non-adherent to buprenorphine. We balanced baseline characteristics between groups using an inverse probability treatment weighting approach. We then evaluated the associations between adherence and the risks of opioid overdose and all-cause hospitalization using discrete-time survival and Cox proportional hazards models respectively. Finally, we estimated differences in healthcare spending between adherent and non-adherent patients using generalized linear models.</div></div><div><h3>Results</h3><div>The cohort included 631 patients (379 [60 %] male; mean (SD) age:67 [2.8] years). Among them, 437 (69 %) were adherent to buprenorphine. Patients with a history of chronic pain, mental health disorders, and diabetes were less likely to adhere while higher average daily doses of buprenorphine were associated with increased adherence. Adherence was associated with reduced risks of opioid overdose (HR:0.76; 95%CI:0.59–0.93) and hospitalization (HR:0.55; 95%CI:0.42–0.73). Healthcare spending among adherent patients was $40,200 [95%CI:$54,712-25,687]) lower than in non-adherent patients. These findings were consistent across robustness and sensitivity analyses.</div></div><div><h3>Conclusions</h3><div>Buprenorphine adherence was associated with reduced risks of opioid overdose, hospitalization, and healthcare spending in the overall population of older individuals with OUD. Enhancing adherence to buprenorphine should be prioritized in OUD treatment strategies among this population.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"176 ","pages":"Article 209740"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}