ArticleDrug and alcohol review2026
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.
Article in Drug and alcohol review, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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7 authors.
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Abstract
introductionIn 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.
methodsAmong 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.
resultsAcross 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
conclusionsAmong 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.
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