Drug use patterns and factors related to the use and discontinuation of medications for opioid use disorder in the age of fentanyl: findings from a mixed-methods study of people who use drugs

Hughto, Jaclyn M. W.; Tapper, Abigail; Rapisarda, Sabrina S.; Stopka, Thomas J.; Palacios, Wilson R.; Case, Patricia; Silcox, Joseph; Moyo, Patience; Green, Traci C.

doi:10.1186/s13011-023-00538-x

Substance Abuse Treatment, Prevention, and Policy

Table 3 Multivariable logistic regression analyses examining the association between socio-demographics and the four most prevalent drugs used in the past 30 days among individuals prescribed methadone or buprenorphine for opioid use disorder in Massachusetts (N = 108)

From: Drug use patterns and factors related to the use and discontinuation of medications for opioid use disorder in the age of fentanyl: findings from a mixed-methods study of people who use drugs

DRUG USE – PAST 30 DAYS
	HEROIN/FENTANYL						CRACK COCAINE						BENZODIAZEPINE						PAIN MEDICATION
	aOR	95% CI	P	aOR	95% CI	P	OR	95% CI	P	aOR	95% CI	P	OR	95% CI	P	aOR	95% CI	P	OR	95% CI	P	aOR	95% CI	P
SOCIO-DEMOGRAPHICS
Age
18–30	1.00	---	---	1.00	---	---	1.00	---	---	1.00	---	---	1.00	---	---	1.00	---	---	1.00	---	---	1.00	---	---
31–40	0.75	0.20–2.79	0.66	0.58	0.13–2.54	0.47	3.71	1.17–11.80	0.03	2.72	0.72–10.34	0.14	1.91	0.62–5.89	0.26	2.31	0.69–7.30	0.17	0.57	0.13–2.42	0.44	0.62	0.14–2.85	0.54
41+	0.78	0.22–2.78	0.70	1.00	0.25-4.00	0.995	2.26	0.76–6.68	0.14	1.58	0.45–5.51	0.47	0.78	0.26–2.36	0.67	1.06	0.70–7.70	0.93	0.60	0.15–2.33	0.46	0.70	0.17–2.99	0.63
Gender
Male	1.00	---	---	---	---	---	1.00	---	---	---	---	---	1.00	---	---	---	---	---	1.00	---	---	---	---	---
Female	1.95	0.79–4.85	0.15	---	---	---	1.82	0.84–3.97	0.13	---	---	---	0.92	0.43-2.00	0.84	---	---	---	1.67	0.57–4.87	0.35	---	---	---
Race/Ethnicity
White, non-Hispanic	1.00	---	---	---	---	---	1.00	---	---	---	---	---	1.00	---	---	1.00	---	---	1.00	---	---	---	---	---
Person of color	1.06	0.41–2.75	0.90	---	---	---	0.71	0.31–1.62	0.41	---	---	---	0.45	0.19–1.10	0.08	0.51	0.18–1.43	0.20	1.04	0.33–3.27	0.95	---	---	---
City Type
Large city	2.95	0.56–15.6	0.20	---	---	---	1.93	0.55–6.71	0.53	2.16	0.49–9.54	0.31	1.93	0.55–6.79	0.31	---	---	---	0.39	0.04–3.63	0.41	---	---	---
Medium city	1.39	0.54–3.60	0.49	---	---	---	2.28	0.95–5.45	0.06	2.89	1.04–8.03	0.04	1.63	0.66–4.03	0.29	---	---	---	1.06	0.33–3.41	0.92	---	---	---
Small city or town	1.00	---	---	---	---	---	1.00	---	---	1.00	---	---	1.00	---	---	---	---	---	1.00	---	---
Employment Status
Employed	1.00	---	---	---	---	---	1.00	---	---	---	---	---	1.00	---	---	---	---	---	1.00	---	---	---	---	---
Unemployed	0.83	0.31–2.22	0.71	---	---	---	2.01	0.86–4.68	0.11	---	---	---	1.07	0.45–2.51	0.88	---	---	---	1.25	0.37–4.21	0.72	---	---	---
Housing Status
Stable	1.00	---	---	---	---	---	1.00	---	---	---	---	---	1.00	---	---	---	---	---	1.00	---	---	---	---	---
Unstable	0.52	0.21–1.27	0.15	---	---	---	1.45	0.67–3.11	0.35	---	---	---	2.23	1.01–4.91	0.0047	2.32	0.97–5.55	0.06	0.96	0.33–2.77	0.94	---	---	---
History of Sex Work
No	1.00	---	---	---	---	---	1.00	---	---	1.00	---	---	1.00	---	---	---	---	---	1.00	---	---	---	---	---
Yes	0.99	0.97–1.02	0.61	---	---	---	1.02	1.00-1.04	0.04	1.03	1.00-1.05	0.03	1.00	0.98–1.02	0.68	---	---	---	1.01	0.98–1.04	0.59	---	---	---
Has a Regular Healthcare Provider
No	1.00	---	---	---	---	---	1.00	---	---	---	---	---	1.00	---	---	---	---	---	1.00	---	---	---	---	---
Yes	0.43	0.12–1.58	0.20	---	---	---	1.70	0.65–4.42	0.28	---	---	---	0.5	0.20–1.33	0.16	---	---	---	1.03	0.26–3.98	0.97	---	---	---
DRUG USE
Number of Times Overdosed
Continuous	1.10	0.95–1.26	0.21	---	---	---	1.13	0.99–1.29	0.07	1.07	0.97–1.19	0.18	1.02	0.98–1.06	0.27	---	---	---	0.88	0.71–1.09	0.25	---	---	---
Overdosed in Past Year
No	1.00	---	---	---	---	---	1.00	---	---	---	---	---	1.00	---	---	---	---	---	1.00	---	---	---	---	---
Yes	1.15	0.47–2.81	0.76	---	---	---	1.78	0.80–3.95	0.16	---	---	---	1.78	0.81–3.91	0.15	---	---	---	0.70	0.23–2.18	0.54	---	---	---
Number of Times Witnessed an Overdose
Continuous	1.03	0.99–1.08	0.12	---	---	---	1.01	0.99–1.03	0.58	---	---	---	0.99	0.97–1.01	0.49	---	---	---	0.88	0.79–0.996	0.04	0.89	0.79–0.997	0.04
Crack Cocaine Use - Past 30 Days
No	1.00	---	---	---	---	---	1.00	---	---	---	---	---	1.00	---	---	---	---	---	1.00	---	---	---	---	---
Yes	0.90	0.37–2.19	0.82	---	---	---	---	---	---	---	---	---	0.77	0.35–1.67	0.50	---	---	---	0.95	0.32–2.76	0.92	---	---	---
Benzodiazepine Use - Past 30 Days
No	1.00	---	---	1.00	---	---	1.00	---	---	---	---	---	---	---	---	---	---	---	1.00	---	---	---	---	---
Yes	3.02	1.11–8.21	0.03	3.27	1.11–9.65	0.03	0.77	0.35–1.67	0.50	---	---	---	---	---	---				2.27	0.78–6.64	0.13	---	---	---
Pain Medication Use - Past 30 Days
No	1.00	---	---	---	---	---	1.00	---	---	---	---	---	1.00	---	---	---	---	---	---	---	---	---	---	---
Yes	0.49	0.16–1.52	0.22	---	---	---	0.91	0.31–2.66	0.87	---	---	---	2.27	0.78–6.64	0.13	---	---	---	---	---	---	---	---	---
Heroin or Fentanyl Use - Past 30 Days
No	---	---	---	---	---	---	1.00	---	---	---	---	---	1.00	---	---	1.00	---	---	1.00	---	---	---	---	---
Yes	---	---	---	---	---	---	0.90	0.37–2.19	0.82	---	---	---	2.94	1.08–8.06	0.04	3.77	1.21–11.72	0.02	0.49	0.16–1.52	0.22	---	---	---
MOUD USE
Number of Times on MOUD
Continuous	0.98	0.93–1.04	0.51	---	---	---	1.16	0.99–1.36	0.07	1.13	0.96–1.32	0.14	0.96	0.88–1.04	0.33	---	---	---	0.81	0.61–1.07	0.13	---	---	---
MOUD Type
Buprenorphine	1.00	---	---	1.00	---	---	1.00	---	---	1.00	---	---	1.00	---	---	1.00	---	---	1.00	---	---	1.00	---	---
Methadone	6.19	1.97–19.51	0.002	6.61	2.03–21.56	0.002	0.94	0.43–2.03	0.87	0.82	0.32–2.14	0.69	1.30	0.60–2.84	0.50	1.10	0.43–2.86	0.84	0.78	0.26–2.33	0.66	0.69	0.22–2.19	0.53

aOR = Adjusted Odds Ratio; CI = Confidence Intervals; P = P-Value; Bolded values = significant at p < 0.05; Italicized P-Values = p < 0.10.
Note. Naltrexone was excluded from the models as the small cell sizes precluded multivariable analyses. Variables with a p-value of < 0.10 in bivariate analyses were included in the multivariable model. Since older individuals have more years to use drugs and MOUD than younger individuals, all multivariable models adjusted for age.

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