ArticleAddiction (Abingdon, England)2023
Polydrug use among patients on methadone medication treatment: Evidence from urine drug testing to inform patient safety.
Article in Addiction (Abingdon, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 20 citations in OpenAlex.
- Barriers and facilitators to methadone dispensing for opioid use disorder in community pharmacies: A scoping review.Drug and alcohol dependence reports · 2026Review
- The HEALing Measurement Center: a stepped wedge cluster randomized study protocol to enhance opioid use disorder recovery through measurement based care.Implementation science : IS · 2026Article
- Duration of Methadone and Buprenorphine-Naloxone Treatment.JAMA network open · 2025Article
- Methadone-involved overdose deaths in urban and rural communities before and after the public health emergency flexibilities for methadone take-home doses.Drug and alcohol dependence reports · 2025Article
- A cross-sectional study of differences in medication for opioid use disorder receipt among pregnant people enrolled in Medicaid in Oregon, United States.Addiction (Abingdon, England) · 2025Article
- Using the IFASIS (Inventory of Factors Affecting Successful Implementation and Sustainment) to advance context-specific and generalizable knowledge of implementation determinants: case study of a digital contingency management platform.Implementation science communications · 2025Article
- Psychometric performance of tools to measure internalized drug use stigma among people who use drugs and people on medication-assisted treatment in Dar es Salaam, Tanzania.Drug and alcohol dependence · 2024Article
- Article
- Association of Daily Doses of Buprenorphine With Urgent Health Care Utilization.JAMA network open · 2024Article
- Access to treatment before and after Medicare coverage of opioid treatment programs.Health affairs scholar · 2024Article
- The impact of methamphetamine use on medications for opioid use disorder (MOUD) treatment retention: a scoping review.Addiction science & clinical practice · 2023Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
aimsPatients in methadone medication treatment for opioid use disorder (M-MOUD) typically have a complex history of opioid use, often in combination with other drugs. It is unknown how frequently M-MOUD patients experience persistent substance or polysubstance use. We measured trends in illicit substance use in a large, multistate population of M-MOUD patients and persistence of substance use in the first year of treatment.
designRetrospective cohort study of United States (US) M-MOUD patients from 2017 to 2021, focused on urine drug specimens provided for testing to Millennium Health, a third-party laboratory. Specimens were analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Generalized estimating equations (GEE) were used to estimate the average trends in positivity during time in treatment.
settingSpecimens were obtained from clinics in 10 US states that provided at least 300 unique patients during the study period (Alaska, Arizona, Florida, Illinois, Kentucky, Minnesota, New Mexico, Ohio, Virginia and Washington).
participantsPatients with opioid use disorder receiving M-MOUD (n = 16 386). MEASUREMENTS: Positivity rates for heroin, fentanyl, methamphetamine and cocaine.
findingsFrom 2017 to 2021, yearly crude positivity rates for first collected specimens increased for fentanyl (13.1%-53.0%, P < 0.001), methamphetamine (10.6%-27.2%, P < 0.001) and cocaine (13.8%-19.5%, P < 0.001); for heroin positivity did not significantly change (6.9%-6.5%, P = 0.74). In regression models estimating patient trajectories from week 1 to week 52, marginal fentanyl positivity declined from 21.8% to 17.1% (incidence rate ratio [IRR] = 0.78, P < 0.001) and heroin positivity declined from 8.4% to 4.3% (IRR = 0.51, P < 0.001), but positivity for methamphetamine and cocaine did not significantly change, remaining at an average of 17.7% (IRR = 0.98, P = 0.53) and 9.2% (IRR = 0.96, P = 0.36), respectively.
conclusionsBetween 2017 and 2021, United States patients presenting to opioid treatment programs increasingly tested positive for fentanyl, methamphetamine and cocaine. Methadone medication treatment for opioid use disorder appears to remain an effective intervention for reducing illicit opioid use.
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