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Nonopioid Substance Use among Patients Who Recently Initiated Office-based Buprenorphine Treatment
Karen L Dugosh1, Michelle R Lent, S Brook Burkley
1From the Research and Evaluation Group, Public Health Management Corporation, Philadelphia, PA (KLD, SBB, CMKM); School of Professional and Applied Psychology, Philadelphia College of Osteopathic Medicine, Philadelphia, PA (MRL); Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA (JRM, KMK).
Objectives:
Medications for opioid use disorder (MOUDs) like buprenorphine are a first-line treatment for individuals who have opioid use disorder (OUD); however, these medications are not designed to impact the use of other classes of drugs. This descriptive study provides up-to-date information about nonopioid substance use among patients who recently initiated office-based buprenorphine treatment for OUD using data from 2 ongoing clinical trials.
Methods:
The study sample was composed of 257 patients from 6 federally qualified health centers in the mid-Atlantic region who recently (i.e., within the past 28 days) initiated office-based buprenorphine treatment between July 2020 and May 2022. After the screening and informed consent processes, participants completed a urine drug screen and psychosocial interview as a part of the study baseline assessment. Descriptive analyses were performed on urine drug screen results to identify the prevalence and types of substances detected.
Results:
More than half of participants provided urine specimens that were positive for nonopioid substances, with marijuana (37%, n = 95), cocaine (22%, n = 56), and benzodiazepines (11%, n = 28) detected with the highest frequencies.
Conclusions:
A significant number of participants used nonopioid substances after initiating buprenorphine treatment, suggesting that some patients receiving MOUDs could potentially benefit from adjunctive psychosocial treatment and supports to address their nonopioid substance use.
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