A systematic review of patients' and providers' perspectives of medications for treatment of opioid use disorder

Cioe, Katharine; Biondi, Breanne E.; Easly, Rebecca; Simard, Amanda; Zheng, Xiaoying; Springer, Sandra A.

doi:10.1016/j.jsat.2020.108146

Cited by 109 publications

(86 citation statements)

References 171 publications

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“…Low utilization rates of OUD pharmacotherapies have also been observed in other studies [1,12,16]. Despite Sweden's stricter inclusion criteria, entry for maintenance treatment does not require failed attempts of detoxification prior to opioid agonist treatment [28].…”

Section: Discussionmentioning

confidence: 69%

“…This inclusion criterion is stricter than in other Nordic countries [28] and may lead to a lower rate of pharmacological treatment for OUD. Low utilization rates of OUD pharmacotherapies have also been observed in other studies [1, 12, 16]. Despite Sweden’s stricter inclusion criteria, entry for maintenance treatment does not require failed attempts of detoxification prior to opioid agonist treatment [28].…”

Section: Discussionmentioning

confidence: 83%

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Real‐world effectiveness of pharmacological treatments of opioid use disorder in a national cohort

et al. 2022

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Aim To investigate the real‐world effectiveness of pharmacological treatments (buprenorphine, methadone) of opioid use disorder (OUD). Design A nation‐wide, register‐based cohort study. Setting Sweden. Participants All residents aged 16–64 years living in Sweden using OUD medication from July 2005 to December 2016 (n = 5757, 71.8% men) were identified from registers of prescriptions, inpatient and specialized outpatient care, causes of death, sickness absence and disability pensions. Measurements Main outcome: hospitalization due to OUD. Secondary outcomes: hospitalization due to any cause; death due to all, natural and external causes. Mortality was analyzed with between‐individual multivariate‐adjusted Cox hazards regression model. Recurrent outcomes, such as hospitalizations, were analyzed with within‐individual analyses to eliminate selection bias. OUD medication use versus non‐use was modelled with PRE2DUP (from prescription drug purchases to drug use periods) method. Findings Buprenorphine [hazard ratio (HR) = 0.73, 95% confidence interval (CI) = 0.54–0.97] and methadone (HR = 0.74, 95% CI = 0.59–0.93) use were associated with significantly lower risk of OUD hospitalization, but not any‐cause hospitalizations, compared with the time‐periods when the same individual did not use OUD medication. The use of buprenorphine and methadone were both associated with significantly lower risk of all‐cause mortality (HR = 0.45, 95% CI = 0.34–0.59; HR = 0.51, 95% CI = 0.41–0.63, respectively), compared with non‐use of both medications. Similar results were found for risk of mortality due to external causes (HR = 0.39; 95% CI = 0.27–0.54; HR = 0.40; 95% CI = 0.29–0.53, respectively), but not for mortality due to natural causes. The risk of OUD hospitalization and all‐cause mortality was decreased in all duration categories of studied medications (< 30, 31–180, 181–365 and >365 days), except for methadone use less than 30 days. Conclusions The use of buprenorphine and methadone are both associated with a significantly lower risk of hospitalization due to opioid use disorder and death due to all and external causes, when compared with non‐use.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 83%

Real‐world effectiveness of pharmacological treatments of opioid use disorder in a national cohort

et al. 2022

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“…This requirement created multiple barriers for PWUD trying to access MOUD. 37 – 39 , 40 , 41 , 42 At the onset of the COVID-19 pandemic, the U.S. government waived the Ryan Haight Act’s in-person examination requirement for the initial consultation for buprenorphine treatment, thus permitting the initial consultation to be held via telemedicine for the duration of the COVID-19 emergency. 43 This policy shift allowed SSP leadership to prepare for and implement telemedicine initiatives for buprenorphine treatment in the midst of the COVID-19 pandemic.…”

Section: Introductionmentioning

confidence: 99%

Ingenuity and resiliency of syringe service programs on the front lines of the opioid overdose and COVID-19 crises

Wenger¹,

Kral²,

Bluthenthal³

et al. 2021

Translational Research

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Another limitation is that we do not measure whether methadone use responded to Rhode Island's ACA implementation, nor how utilization of methadone and buprenorphine might have interacted with each other in the wake of the ACA. Although both medications have been found highly effective in treating OUD, research suggests that many patients have a preference for buprenorphine over methadone owing to its greater convenience and less stigmatized perception (Cioe et al 2020), while methadone may be more effective for patients with very severe OUD. As the APCD data on methadone treatment have been found to be less reliable than the buprenorphine data, and the potential for expansion of MOUD has been focused on buprenorphine in recent years, the choice to focus on buprenorphine is well founded.…”

Section: Discussionmentioning

confidence: 99%

Did the Affordable Care Act Affect Access to Medications for Opioid Use Disorder among the Already Insured? Evidence from the Rhode Island All-payer Claims Database

Burke¹,

Carman²,

Sullivan³

et al. 2021

Federal Reserve Bank of Boston Research Department Working Papers

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Previous research suggests that state Medicaid expansions implemented under the Patient Protection and Affordable Care Act (ACA) helped large numbers of patients suffering from opioid use disorder (OUD) gain access to life-saving medications, including buprenorphine. However, Medicaid expansions could have impeded access to care among individuals already enrolled in Medicaid, as new enrollees would have placed added demands on a limited supply of buprenorphine providers. Using a panel data set of medical claims from Rhode Island, we estimate the causal effects of the state's January 2014 ACA implementation on buprenorphine receipt among incumbent (pre-ACA) Medicaid enrollees by leveraging geographic variation within Rhode Island in the intensity of treatment under the ACA. Using a difference-in-differences identification strategy, multivariate regression analysis yields no evidence that incumbent Medicaid enrollees experienced added difficulties in accessing buprenorphine as a result of the ACA, despite the fact that both Medicaid and non-Medicaid enrollment increased substantially under the policy. Supply-side factors may have helped to blunt any negative fallout, as we find that the number of buprenorphine prescribers in the state increased fairly steadily during the two years leading up to January 2014 and for at least 15 months after that date. Also, the average number of buprenorphine recipients per prescriber increased rapidly after January 2014, suggesting that providers had unused treatment capacity before the policy went into effect.

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A systematic review of patients' and providers' perspectives of medications for treatment of opioid use disorder

Cited by 109 publications

References 171 publications

Real‐world effectiveness of pharmacological treatments of opioid use disorder in a national cohort

Real‐world effectiveness of pharmacological treatments of opioid use disorder in a national cohort

Ingenuity and resiliency of syringe service programs on the front lines of the opioid overdose and COVID-19 crises

Did the Affordable Care Act Affect Access to Medications for Opioid Use Disorder among the Already Insured? Evidence from the Rhode Island All-payer Claims Database

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