Concurrent Use of Extra-Medical Medication for Opioid Use Disorder Among Adults Prescribed Methadone or Buprenorphine: A Cohort Study of Urban Adults Who Have Injected Drugs.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος:	Concurrent Use of Extra-Medical Medication for Opioid Use Disorder Among Adults Prescribed Methadone or Buprenorphine: A Cohort Study of Urban Adults Who Have Injected Drugs.
Συγγραφείς:	Moon KJ; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA., Genberg BL; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA., Astemborski J; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA., German D; Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA., Kirk GD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.; Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Mehta SH; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA., Feder KA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Πηγή:	Drug and alcohol review [Drug Alcohol Rev] 2026 Jul; Vol. 45 (5), pp. e70204.
Τύπος έκδοσης:	Journal Article
Γλώσσα:	English
Στοιχεία περιοδικού:	Publisher: Wiley-Blackwell Country of Publication: Australia NLM ID: 9015440 Publication Model: Print Cited Medium: Internet ISSN: 1465-3362 (Electronic) Linking ISSN: 09595236 NLM ISO Abbreviation: Drug Alcohol Rev Subsets: MEDLINE
Imprint Name(s):	Publication: Original Publication: Abingdon, Oxfordshire, U.K. : Carfax Pub. Co.
Ιατρικοί όροι (MeSH):	Methadone/therapeutic use , Buprenorphine/therapeutic use , Opioid-Related Disorders/drug therapy , Opioid-Related Disorders/epidemiology , Substance Abuse, Intravenous/epidemiology , Opiate Substitution Treatment, Baltimore/epidemiology ; Humans ; Female ; Male ; Middle Aged ; Cohort Studies ; Adult ; Urban Population
Περίληψη:	Introduction: In a policy environment with constrained access to the medications for opioid use disorder (MOUD), we examined the prevalence and correlates of extra-medical use of these medications among individuals already prescribed MOUD. Methods: Among 641 adults in Baltimore participating in the ALIVE cohort study, who self-reported buprenorphine or methadone treatment, we estimated the prevalence of using these same medications outside a formal treatment context ("extra-medical MOUD"). Using logistic regression with generalised estimating equations to account for clustering within individuals, we assess behavioural, sociodemographic, and clinical correlates of extra-medical MOUD use in this population. Results: Across 1325 visits in January 2023-December 2024 (73% aged ≥ 50 years, 68% Black, 64% male), 129 (10%) reported use of extra-medical MOUD. Use of multiple substances (OR 6.05 [95% CI 3.96, 9.23]), injection drug use (6.79 [4.30, 10.70]), any withdrawal sickness (5.51 [3.62, 8.38]) and depressive symptoms (3.90 [2.64, 5.76]) were significantly associated with extra-medical MOUD use. Those engaged in methadone treatment ≥ 6 months had significantly lower odds of extra-medical use (adjusted OR [aOR]: 0.42 [0.22, 0.80]), compared with those newly engaged. By contrast, prescribed buprenorphine dose, but not duration of engagement, was associated with extra-medical use. Discussion and Conclusions: Among adults receiving legally prescribed or dispensed buprenorphine or methadone, extra-medical use of these same medications was reported at one in every 10 visits. Those with heightened vulnerability to drug-related harms were most likely to use extra-medical MOUD. Findings have implications for policies and practices restricting treatment access. (© 2026 The Author(s). Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.)
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Grant Information:	U01 DA036297 United States DA NIDA NIH HHS; P30 AI094189 United States AI NIAID NIH HHS; R01-DA-057673 United States DA NIDA NIH HHS; R01 DA057673 United States DA NIDA NIH HHS; Center for AIDS Research, Johns Hopkins University, CFAR Scholar Grant for Faculty Development; U01-DA-036297 United States DA NIDA NIH HHS; 1P30AI094189 United States NH NIH HHS
Contributed Indexing:	Keywords: epidemiology; harm reduction; medication for opioid use disorder; opioid agonist therapy; risk environment
Substance Nomenclature:	UC6VBE7V1Z (Methadone) 40D3SCR4GZ (Buprenorphine)
Entry Date(s):	Date Created: 20260630 Date Completed: 20260630 Latest Revision: 20260726
Update Code:	20260726
PubMed Central ID:	PMC13316725
DOI:	10.1111/dar.70204
PMID:	42376697
Βάση Δεδομένων:	MEDLINE

Περιγραφή
ISSN:	1465-3362
DOI:	10.1111/dar.70204