Opioid Use Disorder and Treatment Uptake Among Patients With Rheumatic Conditions in the All of Us Research Program:...

Area of Science:

• Rheumatology
• Addiction Medicine
• Public Health

Background:

• Opioid use disorder (OUD) presents significant morbidity and mortality risks.
• Rheumatic conditions like osteoarthritis (OA), rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and spondyloarthritis (SpA) are common.
• Co-occurrence of rheumatic diseases and OUD requires understanding patient profiles and treatment access.

Purpose of the Study:

• To characterize patients with rheumatic conditions and OUD.
• To evaluate the uptake of medications for opioid use disorder (MOUD) in this patient group.
• To identify disparities in care and potential barriers to MOUD.

Main Methods:

• Utilized the All of Us Research Program database (Version 8).
• Identified patients with rheumatic conditions (OA, SLE, RA, SpA) and OUD using billing codes.
• Compared demographics, comorbidities, medication use (opioids, DMARDs), and acute care utilization between patients with and without OUD.

Main Results:

• 4% of 37,282 patients with rheumatic conditions had OUD.
• Patients with OUD were younger, more likely to have Medicaid, comorbidities, and higher acute care use.
• MOUD uptake was 14.5%, significantly lower than national estimates (25%), with less DMARD use.

Conclusions:

• Patients with rheumatic conditions and OUD have distinct characteristics, including lower DMARD use and higher acute care needs.
• Low MOUD uptake highlights potential access barriers for this vulnerable population.
• Further investigation is crucial to address challenges and improve MOUD accessibility for rheumatic disease patients with OUD.