Methamphetamine use and utilization of medications for opioid use disorder among rural people who use drugs

doi:10.1016/j.drugalcdep.2023.110911

Methamphetamine use and utilization of medications for opioid use disorder among rural people who use drugs

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

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.

Original language	English
Article number	110911
Journal	Drug and Alcohol Dependence
Volume	250
DOIs	https://doi.org/10.1016/j.drugalcdep.2023.110911
State	Published - Sep 1 2023

Bibliographical note

Publisher Copyright:
© 2023

Funding

This publication is based upon data collected and/or methods developed as part of the Rural Opioid Initiative (ROI), a multi-site study with a common protocol which was developed collaboratively by investigators at eight research institutions and at the National Institute of Drug Abuse (NIDA), the Appalachian Regional Commission (ARC), the Centers for Disease Control and Prevention (CDC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). Research presented in this publication is the result of secondary data harmonization and analysis and supported by grant U24DA048538 from NIDA . Primary data collection was supported by grants UG3DA044829/UH3DA044829 , UG3DA044798/UH3DA044798 , UG3DA044830/UH3DA044830 , UG3DA044823/UH3DA044823 , UG3DA044822/UH3DA044822 , UG3DA044831/UH3DA044831 , UG3DA044825 , UG3DA044826/UH3DA044826 , and U24DA044801 co-funded by NIDA , ARC , CDC , and SAMHSA . The authors thank the other ROI investigators and their teams, the ROI Executive Steering Committee chair, Dr. Holly Hagan, the NIDA Science Officer, Dr. Richard Jenkins, and particularly, the participants of the individual ROI studies for their valuable contributions. A full list of participating ROI investigators and institutions can be found on the ROI website at http://ruralopioidinitiative.org/studies.html . This publication is based upon data collected and/or methods developed as part of the Rural Opioid Initiative (ROI), a multi-site study with a common protocol which was developed collaboratively by investigators at eight research institutions and at the National Institute of Drug Abuse (NIDA), the Appalachian Regional Commission (ARC), the Centers for Disease Control and Prevention (CDC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). Research presented in this publication is the result of secondary data harmonization and analysis and supported by grant U24DA048538 from NIDA. Primary data collection was supported by grants UG3DA044829/UH3DA044829, UG3DA044798/UH3DA044798, UG3DA044830/UH3DA044830, UG3DA044823/UH3DA044823, UG3DA044822/UH3DA044822, UG3DA044831/UH3DA044831, UG3DA044825, UG3DA044826/UH3DA044826, and U24DA044801 co-funded by NIDA, ARC, CDC, and SAMHSA. The authors thank the other ROI investigators and their teams, the ROI Executive Steering Committee chair, Dr. Holly Hagan, the NIDA Science Officer, Dr. Richard Jenkins, and particularly, the participants of the individual ROI studies for their valuable contributions. A full list of participating ROI investigators and institutions can be found on the ROI website at http://ruralopioidinitiative.org/studies.html.

Funders	Funder number
Rural Opioid Initiative
National Institute on Drug Abuse
Centers for Disease Control and Prevention
Substance Abuse and Mental Health Services Administration	UG3DA044829/UH3DA044829, UG3DA044798/UH3DA044798, UG3DA044826/UH3DA044826, UG3DA044823/UH3DA044823, U24DA048538, UG3DA044831/UH3DA044831, UG3DA044822/UH3DA044822, UG3DA044830/UH3DA044830, UG3DA044825, U24DA044801
Appalachian Regional Commission
Automotive Research and Testing Center

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being
SDG 16 Peace, Justice and Strong Institutions

Keywords

Amphetamine use
Methamphetamine use
Opioid use disorder
Substance use treatment

ASJC Scopus subject areas

Toxicology
Pharmacology
Psychiatry and Mental health
Pharmacology (medical)

Access to Document

10.1016/j.drugalcdep.2023.110911

Cite this

@article{70a10624b59d429fbc4a7c2b4b4e5d5e,

title = "Methamphetamine use and utilization of medications for opioid use disorder among rural people who use drugs",

abstract = "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.",

keywords = "Amphetamine use, Methamphetamine use, Opioid use disorder, Substance use treatment",

author = "Tsui, \{Judith I.\} and Whitney, \{Bridget M.\} and Korthuis, \{P. Todd\} and Brian Chan and Pho, \{Mai T.\} and Jenkins, \{Wiley D.\} and Young, \{April M.\} and Cooper, \{Hannah L.F.\} and Friedmann, \{Peter D.\} and Stopka, \{Thomas J.\} and \{de Gijsel\}, David and Miller, \{William C.\} and Go, \{Vivian F.\} and Ryan Westergaard and Randall Brown and Seal, \{David W.\} and Zule, \{William A.\} and Judith Feinberg and Smith, \{Gordon S.\} and Mixson, \{L. Sarah\} and Rob Fredericksen and Crane, \{Heidi M.\} and Delaney, \{Joseph A.\}",

note = "Publisher Copyright: {\textcopyright} 2023",

year = "2023",

month = sep,

day = "1",

doi = "10.1016/j.drugalcdep.2023.110911",

language = "English",

volume = "250",

}

TY - JOUR

T1 - Methamphetamine use and utilization of medications for opioid use disorder among rural people who use drugs

AU - Tsui, Judith I.

AU - Whitney, Bridget M.

AU - Korthuis, P. Todd

AU - Chan, Brian

AU - Pho, Mai T.

AU - Jenkins, Wiley D.

AU - Young, April M.

AU - Cooper, Hannah L.F.

AU - Friedmann, Peter D.

AU - Stopka, Thomas J.

AU - de Gijsel, David

AU - Miller, William C.

AU - Go, Vivian F.

AU - Westergaard, Ryan

AU - Brown, Randall

AU - Seal, David W.

AU - Zule, William A.

AU - Feinberg, Judith

AU - Smith, Gordon S.

AU - Mixson, L. Sarah

AU - Fredericksen, Rob

AU - Crane, Heidi M.

AU - Delaney, Joseph A.

PY - 2023/9/1

Y1 - 2023/9/1

N2 - 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.

AB - 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.

KW - Amphetamine use

KW - Methamphetamine use

KW - Opioid use disorder

KW - Substance use treatment

UR - https://www.scopus.com/pages/publications/85166667392

UR - https://www.scopus.com/pages/publications/85166667392#tab=citedBy

U2 - 10.1016/j.drugalcdep.2023.110911

DO - 10.1016/j.drugalcdep.2023.110911

M3 - Article

C2 - 37549545

AN - SCOPUS:85166667392

SN - 0376-8716

VL - 250

JO - Drug and Alcohol Dependence

JF - Drug and Alcohol Dependence

M1 - 110911

ER -

Methamphetamine use and utilization of medications for opioid use disorder among rural people who use drugs

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

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