Journal of substance use and addiction treatment最新文献

{"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}

{"title":"C2: editorial board","authors":"","doi":"10.1016/S2949-8759(25)00112-2","DOIUrl":"10.1016/S2949-8759(25)00112-2","url":null,"abstract":"","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"175 ","pages":"Article 209733"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253366","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 of state medicaid prescription cap policies with trajectories of buprenorphine use for opioid use disorder","authors":"Patience M. Dow ,&nbsp;Miriam George ,&nbsp;Landon D. Hughes ,&nbsp;Corinne Roma ,&nbsp;Theresa I. Shireman ,&nbsp;Julie M. Donohue ,&nbsp;Lisa Peterson ,&nbsp;Jaclyn M.W. Hughto","doi":"10.1016/j.josat.2025.209739","DOIUrl":"10.1016/j.josat.2025.209739","url":null,"abstract":"<div><h3>Background</h3><div>Buprenorphine and other medications for opioid use disorder (OUD) can reduce opioid-related morbidity and mortality. It is unknown whether state Medicaid prescription cap policies that restrict the monthly number of covered prescription fills affect the duration of buprenorphine use.</div></div><div><h3>Objective</h3><div>To identify trajectories of buprenorphine use and determine the association of caps with trajectory group membership among individuals with OUD.</div></div><div><h3>Methods</h3><div>Using 10 states' Medicaid claims data from 2010 to 2015, we employed group-based trajectory models to identify patterns of buprenorphine fills over 12 months. We conducted multinomial logistic regression to estimate the association of cap policies with buprenorphine trajectory group membership, adjusting for individual- and state-level covariates.</div></div><div><h3>Results</h3><div>Among 69,306 Medicaid enrollees with OUD who initiated buprenorphine, 16.9 % resided in states with caps. The mean age was 36.2 (SD = 9.8) years and 59.2 % were female. We identified five trajectories: consistent use (40.9 %), delayed discontinuation (14.5 %), early discontinuation (26.4 %), gradually declining use (9.5 %), and rebounding use (8.8 %). Caps were associated with greater risk of membership in the early discontinuation group (adjusted relative risk ratio = 1.47, 95%CI = 1.36,1.59, referent = consistent use). Younger age, male sex, Black race, Hispanic ethnicity, non-opioid substance use disorder, history of acute care utilization were also positively associated with early discontinuation.</div></div><div><h3>Conclusions</h3><div>Medicaid cap policies were associated with increased likelihood of early discontinuation and other trajectories of inconsistent buprenorphine use relative to states without these policies. Medicaid's prominence as a payer for OUD treatment and 12 states' continued implementation of caps warrant safeguards to ensure cap policies do not undermine buprenorphine access.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"176 ","pages":"Article 209739"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276936","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)00107-9","DOIUrl":"10.1016/S2949-8759(25)00107-9","url":null,"abstract":"","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"174 ","pages":"Article 209728"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241753","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":"C2: editorial board","authors":"","doi":"10.1016/S2949-8759(25)00106-7","DOIUrl":"10.1016/S2949-8759(25)00106-7","url":null,"abstract":"","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"174 ","pages":"Article 209727"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144241752","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":"Medicaid health home design and buprenorphine receipt, 2009–2020","authors":"Christina M. Andrews ,&nbsp;Theodoros Giannouchos ,&nbsp;Angela Rogers ,&nbsp;Melissa A. Westlake","doi":"10.1016/j.josat.2025.209738","DOIUrl":"10.1016/j.josat.2025.209738","url":null,"abstract":"<div><h3>Introduction</h3><div>In the midst of an escalating opioid epidemic, innovative models of care are critical to expand access to opioid use disorder treatment. The Medicaid health home program, which costs the nation $1 billion annually, is intended to improve identification and treatment for enrollees with complex chronic conditions, including opioid use disorder. In this study, we assess the association of state-level Medicaid health home policies related to substance use disorder screening and health home eligibility with trends in prescriptions for buprenorphine, a medication that dramatically reduces risk of opioid-related overdose and mortality.</div></div><div><h3>Methods</h3><div>We use Medicaid data on buprenorphine prescriptions from 2009 to 2020 and a difference in differences methodology accounting for variation in treatment timing. Our treatment groups are states that require health homes to screen for substance use disorder and states that had at least one health home that has substance use disorder as a qualifying condition.</div></div><div><h3>Results</h3><div>We find no significant difference in rates of buprenorphine prescriptions filled among states that require screening for substance use disorder and those that do not. We also do not find significant differences in buprenorphine prescriptions between states that designate substance use disorder as a qualifying condition for health home participation and those that do not.</div></div><div><h3>Conclusion</h3><div>Health home policies intended to reach opioid use disorder patients are not increasing buprenorphine receipt, which is one key measure of opioid use disorder treatment. State Medicaid programs should assess strategies to enhance health home performance in facilitating access opioid use disorder treatment.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"176 ","pages":"Article 209738"},"PeriodicalIF":0.0,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253427","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":"Characteristics of substance use disorder and mental health disorder treatment facilities with perinatal programs","authors":"Brooke N. Lombardi ,&nbsp;Anna B. Parisi ,&nbsp;Helen Newton ,&nbsp;Brianna M. Lombardi","doi":"10.1016/j.josat.2025.209722","DOIUrl":"10.1016/j.josat.2025.209722","url":null,"abstract":"<div><h3>Background</h3><div>Substance use disorders (SUD) and mental health disorders (MHD) are major health concerns during the perinatal period (conception to one year postpartum). However, many individuals with perinatal SUD or MHD do not receive adequate treatment, and most treatment facilities do not offer services tailored to this population's unique needs. This study examines the proportion of treatment facilities in the United States (US) providing perinatal services, as well as facility- and state-level factors associated with offering such services.</div></div><div><h3>Methods</h3><div>Data were drawn from the 2022 National Substance Use and Mental Health Services Survey, an annual cross-sectional survey of all known public and private SUD and MHD treatment facilities in the US. The sample consisted of 6995 facilities providing SUD treatment (SUD-only) and 9134 facilities offering combined SUD and MHD treatment. Descriptive statistics, bivariate analyses, and multilevel logistic regression models examined treatment facility characteristics and the impact of facility- and state-level factors on the likelihood of offering perinatal services.</div></div><div><h3>Results</h3><div>Only 32.7% of SUD-only treatment facilities and 31.1% of combined SUD/MHD treatment facilities offered perinatal programs. More than half of these treatment facilities provided services critical to the perinatal population, including transportation assistance, social service support, trauma-informed therapy, and telehealth. Payment type (i.e., Medicaid acceptance, offer of free or low-cost treatment), for-profit treatment facility ownership, and receipt of state and federal grant funding were associated with a significantly increased likelihood of the treatment facility providing perinatal services.</div></div><div><h3>Conclusions</h3><div>Findings indicate there is a pressing need for SUD and MHD treatment facilities to expand their services to include care for individuals in the perinatal period, as well as increase the availability of essential services (e.g., integrated primary care) and ancillary services (e.g., childcare). Further research is needed to understand at which timepoint(s) facilities provide treatment (i.e., pregnancy and/or the postpartum period) and which types of essential and ancillary services are most beneficial during the perinatal period.</div></div>","PeriodicalId":73960,"journal":{"name":"Journal of substance use and addiction treatment","volume":"176 ","pages":"Article 209722"},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188645","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}