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Research Summary

Factors Associated with of Receiving Buprenorphine Treatment for Opioid Use Disorders

Buprenorphine provides an alternative to methadone for patients with opioid use disorders, but few studies have focused on patient determinants of buprenorphine treatment. This retrospective cohort analysis studied data from 4030 individuals with an opioid use disorder who sought treatment in a large U.S. managed-care organization. Patients called a centralized triage program where licensed mental health professionals performed a telephone assessment and subsequently referred them to an appointment with a group-model or contracted-network provider.

  • Overall, 17% (n=702) of patients received treatment with buprenorphine.
  • The mean age of individuals receiving buprenorphine treatment compared with an alternative therapy was 32 versus 34 years and 42% of both samples were female. Individuals who received treatment with buprenorphine were less likely to be enrolled in a commercial health plan (61% versus 73%) or Medicaid (1.3% versus 2.9%).
  • Younger age, residing in a metropolitan area, having Drug Addiction Treatment Act 2000-waivered physicians in the area, and having a point-of-service health plan were associated with receipt of treatment with buprenorphine.
  • Having a co-occurring alcohol or non-opioid drug dependency decreased the likelihood of receiving treatment with buprenorphine by 52% and 98%, respectively. Having a comorbid drug-induced mental disorder or chronic pain diagnosis increased the likelihood of receiving treatment with buprenorphine by 221% and 82%, respectively.

Comments:

This study highlights the importance of structural and patient factors associated with receiving treatment with buprenorphine in the U.S. Studies that include other factors such as medication cost, whether waivered physicians are actually prescribing treatment, patient preferences, and prior treatment attempts would shed further light on structural and patient-level factors associated with the type of treatment patients receive for opioid use disorders. Jeanette M. Tetrault, MD

Reference:

Murphy SM, Fishman PA, McPherson S, et al. Determinants of buprenorphine treatment for opioid dependence. J Subst Abuse Treat. 2014;46(3):315–319.

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