Table 1.
Receipt of Buprenorphine and Vivitrol Among Medicaid Patients Diagnosed With Opioid Use Disorder in the U.S., 2017−2019
| Covariates | Patients with opioid use disorder | Buprenorphinea | Vivitrol | Neither | |||
|---|---|---|---|---|---|---|---|
| n | n (%) | Overall p-value | n (%) | Overall p-value | n (%) | Overall p-value | |
| Total | 996,641 | 135,941 (13.6) | 21,161 (2.1) | 842,697 (84.6) | |||
| Race/ethnicity | <0.001 | <0.001 | <0.001 | ||||
| White, non-Hispanic | 591,962 | 95,405 (16.1) | 15,075 (2.5) | 483,866 (81.7) | |||
| Black, non-Hispanic | 156,636 | 11,350 (7.2) | 1,690 (1.1) | 143,816 (91.8) | |||
| AIAN/Asian/Hawaiian/Pacific Islander, non-Hispanic | 27,489 | 3,686 (13.4) | 422 (1.5) | 23,433 (85.2) | |||
| Hispanic, all races | 90,422 | 8,973 (9.9) | 1,004 (1.1) | 80,577 (89.1) | |||
| Other/unknown | 130,132 | 16,527 (12.7) | 2,970 (2.3) | 111,005 (85.3) | |||
| Sex | <0.001 | <0.001 | <0.001 | ||||
| Male | 492,619 | 69,357 (14.1) | 11,336 (2.3) | 413,666 (84.0) | |||
| Female | 504,022 | 66,584 (13.2) | 9,825 (1.9) | 429,031 (85.1) | |||
| Age group, years | <0.001 | <0.001 | <0.001 | ||||
| 18–24 | 70,370 | 11,474 (16.3) | 2,216 (3.1) | 57,080 (81.1) | |||
| 25–34 | 299,352 | 56,933 (19.0) | 9,751 (3.3) | 234,281 (78.3) | |||
| 35–44 | 244,770 | 38,434 (15.7) | 5,641 (2.3) | 201,486 (82.3) | |||
| 45–54 | 205,681 | 19,530 (9.5) | 2,588 (1.3) | 183,835 (89.4) | |||
| 55–64 | 176,468 | 9,570 (5.4) | 965 (0.5) | 166,015 (94.1) | |||
| Primary language spoken | <0.001 | <0.001 | <0.001 | ||||
| English | 760,801 | 107,112 (14.1) | 15,849 (2.1) | 640,334 (84.2) | |||
| Non-English | 15,320 | 1,235 (8.1) | 83 (0.5) | 14,013 (91.5) | |||
| Unknown language | 220,520 | 27,594 (12.5) | 5,229 (2.4) | 188,350 (85.4) | |||
| Substance use disorders | |||||||
| Alcohol | 129,734 | 11,071 (8.5) | <0.001 | 5,568 (4.3) | <0.001 | 113,475 (87.5) | <0.001 |
| Cannabis | 88,416 | 9,536 (10.8) | <0.001 | 2,261 (2.6) | <0.001 | 76,922 (87.0) | <0.001 |
| Sedative | 32,571 | 4,646 (14.3) | <0.001 | 996 (3.1) | <0.001 | 27,097 (83.2) | <0.001 |
| Cocaine | 69,670 | 7,664 (11.0) | <0.001 | 2,097 (3.0) | <0.001 | 60,191 (86.4) | <0.001 |
| Nicotine | 186,242 | 25,609 (13.8) | 0.123 | 4,329 (2.3) | <0.001 | 156,975 (84.3) | <0.001 |
| Other | 104,068 | 14,550 (14.0) | <0.001 | 2,788 (2.7) | <0.001 | 87,158 (83.8) | <0.001 |
| Psychiatric diagnosis | |||||||
| Anxiety | 187,812 | 22,860 (12.2) | <0.001 | 3,983 (2.1) | 0.934 | 161,470 (86.0) | <0.001 |
| Bipolar disorder | 90,370 | 8,664 (9.6) | <0.001 | 1,933 (2.1) | 0.730 | 80,015 (88.5) | <0.001 |
| Major depression | 184,802 | 20,715 (11.2) | <0.001 | 4,524 (2.4) | <0.001 | 160,118 (86.6) | <0.001 |
| Other mood disorder | 24,421 | 2,704 (11.1) | <0.001 | 581 (2.4) | 0.005 | 21,202 (86.8) | <0.001 |
| ADHD | 23,819 | 3,143 (13.2) | 0.043 | 518 (2.2) | 0.577 | 20,243 (85.0) | 0.061 |
| PTSD | 50,336 | 5,682 (11.3) | <0.001 | 1,164 (2.3) | 0.003 | 43,634 (86.7) | <0.001 |
| Schizophrenia | 51,125 | 3,324 (6.5) | <0.001 | 636 (1.2) | <0.001 | 47,231 (92.4) | <0.001 |
| Pain diagnosis | |||||||
| Back pain | 224,218 | 18,151 (8.1) | <0.001 | 1,653 (0.7) | <0.001 | 204,658 (91.3) | <0.001 |
| Neck pain | 73,762 | 5,450 (7.4) | <0.001 | 561 (0.8) | <0.001 | 67,825 (92.0) | <0.001 |
| Migraine | 26,515 | 2,339 (8.8) | <0.001 | 296 (1.1) | <0.001 | 23,927 (90.2) | <0.001 |
| Fibromyalgia | 16,805 | 1,119 (6.7) | <0.001 | 88 (0.5) | <0.001 | 15,609 (92.9) | <0.001 |
| Osteoarthritis | 59,743 | 3,560 (6.0) | <0.001 | 362 (0.6) | <0.001 | 55,857 (93.5) | <0.001 |
| Inflammatory joint disorder | 129,837 | 10,894 (8.4) | <0.001 | 1,281 (1.0) | <0.001 | 117,850 (90.8) | <0.001 |
| Other medications | |||||||
| Opioid analgesics | 253,404 | 25,268 (10.0) | <0.001 | 2,314 (0.9) | <0.001 | 226,208 (89.3) | <0.001 |
| Benzodiazepines | 127,461 | 15,069 (11.8) | <0.001 | 2,145 (1.7) | <0.001 | 110,540 (86.7) | <0.001 |
| Antidepressants | 243,812 | 32,166 (13.2) | <0.001 | 6,361 (2.6) | <0.001 | 206,076 (84.5) | 0.624 |
| Stimulants | 24,788 | 3,819 (15.4) | <0.001 | 514 (2.1) | 0.583 | 20,537 (82.9) | <0.001 |
Source: T-MSIS.
ADHD, attention-deficit hyperactivity disorder; AIAN, American Indian/Alaskan Native; PTSD, post-traumatic stress disorder; T-MSIS, Transformed Medicaid Statistical Information System.
a
Buprenorphine formulations for pain treatment (Butrans and Belbuca) were excluded from the analysis.