How Do Patients Diagnosed With Opioid Use Disorders Compare to the Overall US Population of Individuals with Drug Use Disorders?

January 23, 2017

This poster was presented at the 29th Annual U.S. Psychiatric & Mental Health Congress, held October 21-24, 2016, in San Antonio, Texas.

Background: Successful treatment of patients with opioid use disorder (OUD) is an important step in addressing the current opioid epidemic. Recent U.S. surveys describe characteristics and treatments of individuals with self-reported problematic drug use, but no research has examined how these individuals differ from diagnosed OUD patients.
Objective: Compare characteristics of real-world diagnosed OUD populations and populations estimated from nationally-representative surveys.
Methods: Patients with ≥1 claim with an OUD diagnosis code (earliest=index) and ≥6 months pre- and post-index continuous enrollment were selected from administrative claims in the 2008-2014 MarketScan Commercial and Medicaid Databases.  Patient characteristics were measured pre-index and OUD treatment post-index, and discussed in the context of survey results.
Results: Study-eligible OUD patients (N= 103,768 commercially-insured, 50,552 Medicaid) were mean age 36.  Males predominated the commercial (58%), but not the Medicaid sample (36%).  Pre-index comorbidities included depressive disorders (26.9%), alcohol use disorder (7.5%), and other (non-opioid or alcohol) substance use disorders (16.5%).  Psychiatric medication use was common; 43% of patients had claim(s) for antidepressants, 29.1% benzodiazepines, 19.2% non-benzodiazepines sedative/hypnotics, and 12.7% antipsychotics.  Two-thirds received psychosocial or medication-assisted treatment.  Survey research similarly found other substance abuse disorders and psychiatric comorbidity were associated with self-reported problematic drug use, but treatment rates were much lower. 
Conclusions: OUD patients who come to the attention of clinicians share some characteristics with the overall population self-reporting problematic drug use via survey.  Underrepresented groups may be patients needing additional supports to link to diagnosis and treatment, an important first step in the treatment trajectory.    

Authors: 
Bernd Wollschlaeger, MD, FAAFP, FASAM; Leslie Montejano, MA, CCRP; Tina Willson, PhD; Naoko Ronquest, PhD; Vijay Nadipelli, BPharm, MS
Sponsoring Organization: 
Indivior Inc.
Presented By: 
Tina Wilson, Global Director, Indivior Inc., Richmond, VA
Year: 
2016
Tracks: 
Substance Abuse, Addiction & Deterrence