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Statewide Trends in Medications for Opioid Use Disorder Utilization in Rhode Island, United States, 2017-2023
Leah C Shaw1, Benjamin D Hallowell, Taylor Paiva
1Department of Epidemiology, School of Public Health, Brown University, Providence, RI (LCS, EAS, BDLM); Substance Use Epidemiology Program, Rhode Island Department of Health, Providence, RI (BDH, TP, EAS); Rhode Island Executive Office of Health and Human Services, Cranston, RI (CTS); Rhode Island Department of Behavioral Healthcare, Developmental Disabilities & Hospitals, Cranston, RI (MD, SKB, JG); Department of Emergency Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA; Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI (EAS); and Center for Opioid Epidemiology and Policy, Department of Population Health, NYU Grossman School of Medicine, New York University, New York City, NY (MC).
Background:
Buprenorphine and methadone are US Food and Drug Administration-approved medications for opioid use disorder (MOUD). Although utilization of MOUD was increasing pre-COVID-19, it is not well understood how this trend shifted during and "after" the COVID-19 pandemic in Rhode Island. This analysis will consider the differential utilization of MOUD over time and by key demographic factors.
Methods:
We utilized two of Rhode Island's statewide databases to examine aggregate counts of dispensed buprenorphine and methadone from January 1, 2017, to December 31, 2023. Data were stratified by age group, sex assigned at birth, and race/ethnicity (where available). Counts were stratified into pre-COVID-19 (Q1 2017-Q1 2020), COVID-19 (Q2 2020-Q4 2022), and endemic COVID-19 (2023) eras. Averages and annualized percent change for each period were calculated to understand how utilization changed over time.
Results:
Before COVID-19, buprenorphine and methadone utilization were increasing annually. During COVID-19, utilization declined annually by 0.40% and 0.43%, respectively. In the endemic COVID-19 time period, buprenorphine and methadone utilization declined more rapidly at 2.59% and 1.77%, respectively. Declines were more dramatic for adults aged 18-34.
Conclusions:
We observed a decline in MOUD utilization during and after COVID-19 in Rhode Island, primarily driven by substantial decreases in MOUD use among the youngest group of adult residents. Interventions specifically tailored to youth, such as school-based or primary healthcare-based programs, may be particularly effective in engaging with youth in substance use disorder treatment.
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