The Impact of Psychostimulant Use on Office Based Buprenorphine Treatment Retention

Background : Over a million people have died from overdose since 1999, over 600,000 of which involved opioids. Treatment options that focus on overdose prevention as opposed to recovery are desperately needed. Co-morbid opioid and stimulant use disorders have increased at a higher rate than other co-morbid combinations between 2011-2019. Methods : We conducted an analysis of a cohort of 143 individuals with opioid use disorder that initiated treatment in an urban office based opioid treatment (OBOT) clinic. Retention was measured at 1, 3, and 6-months. Logistic regression was used to identify differences between groups. Results : Patients testing positive for cocaine use prior to 6-month follow-up had 5.31 higher odds of not being retained in treatment (95% CI: 1.16-24.38). Patients testing positive for methamphetamine had no significant effect on retention at any of the time points. Conclusion : We attempted to identify the effects of stimulant use on retention in MOUD treatment in a low-threshold OBOT clinic. The findings of this study provide evidence that low resource, low-threshold clinics are viable venues to treat patients with opioid use disorder with co-occurring stimulant use. These findings are critical as access to MOUD treatment is low, and new venues that are easy to access are desperately needed.