Little is known about the impact of medications for opioid use disorder (MOUD) on residential OUD treatment outcomes. Researchers extracted data from a US national dataset of admissions and discharges from publicly funded substance use disorder treatment facilities. Data from adults admitted to either a short-term (ST; <30 days) or long-term (LT; >30 days) OUD residential treatment center between 2015 and 2017 were assessed to determine the effects of MOUD on the probability of treatment completion and retention (defined as a stay >10 days or >90 days for ST and LT treatment, respectively).
- A total of 87,296 and 66,623 adults with OUD received ST or LT treatment, respectively.
- Only 18% of patients received MOUD as part of their treatment plan.
- Among patients who received ST treatment, MOUD was associated with a 40% increased likelihood of treatment completion and 34% increased retention.
- For those who received LT treatment, MOUD was associated with a 26% reduced likelihood of treatment completion and no significant increase in treatment retention.
- Post hoc analyses on the effects of health insurance type on completion and length of stay revealed that Medicaid coverage upon admission could affect treatment completion and retention.
Comments: Despite its established efficacy, MOUD is underutilized in residential treatment settings. However, it may be the case that residential treatment completion does not correlate to whether or not a patient continues treatment overall. As the authors suggest, some patients who feel stable on MOUD may leave residential treatment and continue to receive their medication in another setting. Regardless, MOUD implementation should be prioritized in all treatment settings.
Eisha Lehal, BSc † and Seonaid Nolan, MD
† Contributing Editorial Intern and Clinical Research Coordinator, British Columbia Centre on Substance Use
Reference: Stahler GJ, Mennis J. The effect of medications for opioid use disorder (MOUD) on residential treatment completion and retention in the US. Drug Alcohol Depend. 2020;212:108067.