Methamphetamine use and utilization of medications for opioid use disorder among rural people who use drugs.
Amphetamine use
Methamphetamine use
Opioid use disorder
Substance use treatment
Journal
Drug and alcohol dependence
ISSN: 1879-0046
Titre abrégé: Drug Alcohol Depend
Pays: Ireland
ID NLM: 7513587
Informations de publication
Date de publication:
01 09 2023
01 09 2023
Historique:
received:
07
04
2023
revised:
23
07
2023
accepted:
24
07
2023
pmc-release:
01
09
2024
medline:
22
8
2023
pubmed:
8
8
2023
entrez:
7
8
2023
Statut:
ppublish
Résumé
Methamphetamine use is common among persons with opioid use disorder. This study evaluated associations between methamphetamine use and treatment with agonist medications for opioid use disorder (MOUD, specifically buprenorphine, and/or methadone) in U.S. rural communities. The Rural Opioid Initiative (ROI) is a consortium spanning 10 states and 65 rural counties that included persons who reported past 30-day use of opioids and/or injection drug use between 1/2018 and 3/2020. Analyses were restricted to participants who had ever used opioids and had data on past 30-day methamphetamine use. Multivariable models examined the relationship between methamphetamine use and utilization of agonist MOUD. Among 2899 participants, 2179 (75.2%) also reported recent methamphetamine use. Persons with methamphetamine use compared to those without were younger, more likely to have injected drugs, be unhoused, criminal justice involved, and less likely to have health insurance. Adjusted for age, sex, race, and study site, recent methamphetamine use was associated with lower relative odds of past 30-day methadone treatment (aOR=0.66; 95% CI: 0.45-0.99) and fewer methadone treatment days (aIRR=0.76; 0.57-0.99), but not past 30-day buprenorphine receipt (aOR=0.90; 0.67-1.20), buprenorphine treatment days in past 6 months: aIRR=0.88; 0.69-1.12) or perceived inability to access buprenorphine (aOR=1.12; 0.87-1.44) or methadone (aOR=1.06; 0.76-1.48). Methamphetamine use is common among persons who use opioids in rural U.S. areas and negatively associated with current treatment and retention on methadone but not buprenorphine. Future studies should examine reasons for this disparity and reduce barriers to methadone for persons who use opioids and methamphetamine.
Sections du résumé
BACKGROUND
Methamphetamine use is common among persons with opioid use disorder. This study evaluated associations between methamphetamine use and treatment with agonist medications for opioid use disorder (MOUD, specifically buprenorphine, and/or methadone) in U.S. rural communities.
METHODS
The Rural Opioid Initiative (ROI) is a consortium spanning 10 states and 65 rural counties that included persons who reported past 30-day use of opioids and/or injection drug use between 1/2018 and 3/2020. Analyses were restricted to participants who had ever used opioids and had data on past 30-day methamphetamine use. Multivariable models examined the relationship between methamphetamine use and utilization of agonist MOUD.
RESULTS
Among 2899 participants, 2179 (75.2%) also reported recent methamphetamine use. Persons with methamphetamine use compared to those without were younger, more likely to have injected drugs, be unhoused, criminal justice involved, and less likely to have health insurance. Adjusted for age, sex, race, and study site, recent methamphetamine use was associated with lower relative odds of past 30-day methadone treatment (aOR=0.66; 95% CI: 0.45-0.99) and fewer methadone treatment days (aIRR=0.76; 0.57-0.99), but not past 30-day buprenorphine receipt (aOR=0.90; 0.67-1.20), buprenorphine treatment days in past 6 months: aIRR=0.88; 0.69-1.12) or perceived inability to access buprenorphine (aOR=1.12; 0.87-1.44) or methadone (aOR=1.06; 0.76-1.48).
CONCLUSION
Methamphetamine use is common among persons who use opioids in rural U.S. areas and negatively associated with current treatment and retention on methadone but not buprenorphine. Future studies should examine reasons for this disparity and reduce barriers to methadone for persons who use opioids and methamphetamine.
Identifiants
pubmed: 37549545
pii: S0376-8716(23)01149-3
doi: 10.1016/j.drugalcdep.2023.110911
pmc: PMC10599300
mid: NIHMS1936372
pii:
doi:
Substances chimiques
Analgesics, Opioid
0
Methamphetamine
44RAL3456C
Methadone
UC6VBE7V1Z
Buprenorphine
40D3SCR4GZ
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
110911Subventions
Organisme : NIDA NIH HHS
ID : U24 DA044801
Pays : United States
Organisme : NIDA NIH HHS
ID : UG3 DA044831
Pays : United States
Organisme : NIDA NIH HHS
ID : UG3 DA044825
Pays : United States
Organisme : NIDA NIH HHS
ID : UH3 DA044822
Pays : United States
Organisme : NIDA NIH HHS
ID : UH3 DA044798
Pays : United States
Organisme : NIDA NIH HHS
ID : UG3 DA044798
Pays : United States
Organisme : NIDA NIH HHS
ID : UH3 DA044826
Pays : United States
Organisme : NIDA NIH HHS
ID : U24 DA048538
Pays : United States
Organisme : NIDA NIH HHS
ID : UH3 DA044823
Pays : United States
Organisme : NIDA NIH HHS
ID : UH3 DA044830
Pays : United States
Organisme : NIDA NIH HHS
ID : UG3 DA044822
Pays : United States
Organisme : NIDA NIH HHS
ID : UH3 DA044829
Pays : United States
Organisme : NIDA NIH HHS
ID : UG3 DA044826
Pays : United States
Organisme : NIDA NIH HHS
ID : UG3 DA044823
Pays : United States
Organisme : NIDA NIH HHS
ID : UH3 DA044831
Pays : United States
Organisme : NIDA NIH HHS
ID : UG3 DA044830
Pays : United States
Organisme : NIDA NIH HHS
ID : UG3 DA044829
Pays : United States
Informations de copyright
Copyright © 2023. Published by Elsevier B.V.
Déclaration de conflit d'intérêts
Declaration of Competing Interest None.
Références
Addict Sci Clin Pract. 2021 Oct 11;16(1):62
pubmed: 34635170
Subst Use Misuse. 2017 Jul 3;52(8):1051-1058
pubmed: 28323507
Addiction. 2019 Dec;114(12):2122-2136
pubmed: 31328345
Prev Med. 2021 Nov;152(Pt 2):106541
pubmed: 34482994
Am J Public Health. 2020 Feb;110(2):244-250
pubmed: 31855487
Addiction. 2023 Sep 13;:
pubmed: 37705148
Drug Alcohol Depend. 2023 Apr 1;245:109801
pubmed: 36801707
Drug Alcohol Depend. 2021 Aug 1;225:108844
pubmed: 34182377
Arch Pediatr Adolesc Med. 2011 Aug;165(8):736-40
pubmed: 21810635
JAMA Psychiatry. 2020 Mar 1;77(3):246-255
pubmed: 31825466
N Engl J Med. 2021 Jan 14;384(2):140-153
pubmed: 33497547
BMC Med Res Methodol. 2019 Oct 29;19(1):202
pubmed: 31664912
JAMA Netw Open. 2022 Aug 1;5(8):e2226544
pubmed: 35969400
Int J Drug Policy. 2021 Jan;87:102982
pubmed: 33126164
Drug Alcohol Depend. 2016 Nov 01;168:263-273
pubmed: 27736680
Value Health. 2021 Feb;24(2):188-195
pubmed: 33518025
J Addict Med. 2020 Mar/Apr;14(2):95-98
pubmed: 31567596
Am J Drug Alcohol Abuse. 2022 Mar 4;48(2):226-234
pubmed: 34752718
Front Psychiatry. 2022 Jan 07;12:805002
pubmed: 35069295
JAMA. 2019 Oct 1;322(13):1310-1312
pubmed: 31573628
Am J Epidemiol. 2004 Apr 1;159(7):702-6
pubmed: 15033648
MMWR Morb Mortal Wkly Rep. 2020 Mar 27;69(12):317-323
pubmed: 32214077
J Addict Med. 2020 Mar/Apr;14(2S Suppl 1):1-91
pubmed: 32511106
Front Sociol. 2020 Nov 10;5:593925
pubmed: 33869521
Addict Sci Clin Pract. 2022 Jul 26;17(1):38
pubmed: 35883197
Drug Alcohol Depend. 2018 Jan 1;182:86-92
pubmed: 29175463
J Urban Health. 2010 May;87(3):480-5
pubmed: 20101468
Drug Alcohol Depend. 2018 Dec 1;193:14-20
pubmed: 30326396
Drug Alcohol Depend. 2022 Mar 1;232:109295
pubmed: 35066460
JAMA Health Forum. 2021 Jan 4;2(1):e210001
pubmed: 36218421
J Subst Abuse Treat. 2020 Feb;109:80-85
pubmed: 31810594
Subst Abuse Treat Prev Policy. 2022 Apr 9;17(1):27
pubmed: 35397571
Addiction. 2010 Sep;105(9):1507-9
pubmed: 20707772
J Addict Med. 2021 Jan-Feb 01;15(1):34-39
pubmed: 32530888