Table 2.
AORs for Receipt of Buprenorphine and Vivitrol Within 180 Days After OUD Diagnosis Among Medicaid Patients in the U.S., 2017−2019
| Covariates | Buprenorphine | Vivitrol | ||
|---|---|---|---|---|
| AOR (95% CI) | p-value | AOR (95% CI) | p-value | |
| Race/ethnicity | ||||
| White, non-Hispanic | 1.0 (ref) | 1.0 (ref) | ||
| Black, non-Hispanic | 0.58 (0.57, 0.59) | <0.001 | 0.53 (0.50, 0.56) | <0.001 |
| AIAN/Asian/Hawaiian/Pacific Islander, non-Hispanic | 0.88 (0.84, 0.91) | <0.001 | 0.88 (0.80, 0.98) | 0.018 |
| Hispanic, all races | 0.78 (0.76, 0.80) | <0.001 | 0.80 (0.75, 0.86) | <0.001 |
| Other/unknown | 0.86 (0.84, 0.88) | <0.001 | 0.90 (0.86, 0.94) | <0.001 |
| Sex | ||||
| Male | 1.10 (1.09, 1.12) | <0.001 | 1.06 (1.03, 1.09) | <0.001 |
| Female | 1.0 (ref) | 1.0 (ref) | ||
| Age group, years | ||||
| 18–24 | 1.0 (ref) | 1.0 (ref) | ||
| 25–34 | 1.21 (1.18, 1.24) | <0.001 | 1.05 (1.00, 1.10) | 0.067 |
| 35–44 | 1.02 (1.00, 1.05) | 0.070 | 0.77 (0.73, 0.81) | <0.001 |
| 45–54 | 0.68 (0.66, 0.70) | <0.001 | 0.48 (0.45, 0.51) | <0.001 |
| 55–64 | 0.41 (0.40, 0.42) | <0.001 | 0.26 (0.24, 0.28) | <0.001 |
| Language spoken | ||||
| English | 1.79 (1.65, 1.94) | <0.001 | 1.98 (1.59, 2.47) | <0.001 |
| Non-English | 1.0 (ref) | 1.0 (ref) | ||
| Unknown language | 1.77 (1.63, 1.93) | <0.001 | 2.31 (1.83, 2.90) | <0.001 |
| Substance use disordersa | ||||
| Alcohol | 0.55 (0.54, 0.56) | <0.001 | 2.29 (2.21, 2.37) | <0.001 |
| Cannabis | 0.68 (0.66, 0.69) | <0.001 | 0.80 (0.76, 0.84) | <0.001 |
| Sedative | 1.09 (1.06, 1.13) | <0.001 | 1.21 (1.13, 1.29) | <0.001 |
| Cocaine | 0.93 (0.90, 0.95) | <0.001 | 1.13 (1.07, 1.18) | <0.001 |
| Nicotine | 1.16 (1.14, 1.18) | <0.001 | 1.03 (0.99, 1.07) | 0.112 |
| Other | 1.05 (1.03, 1.07) | <0.001 | 1.04 (1.00, 1.09) | 0.065 |
| Psychiatric diagnosisa | ||||
| Anxiety | 0.97 (0.95, 0.99) | <0.001 | 0.92 (0.88, 0.95) | <0.001 |
| Bipolar disorder | 0.79 (0.77, 0.80) | <0.001 | 0.92 (0.87, 0.97) | 0.001 |
| Major depression | 0.87 (0.86, 0.89) | <0.001 | 1.06 (1.02, 1.10) | 0.002 |
| Other mood disorder | 0.91 (0.87, 0.94) | <0.001 | 0.94 (0.86, 1.03) | 0.166 |
| ADHD | 0.88 (0.84, 0.92) | <0.001 | 0.83 (0.76, 0.92) | <0.001 |
| PTSD | 0.92 (0.89, 0.95) | <0.001 | 0.97 (0.91, 1.04) | 0.378 |
| Schizophrenia | 0.57 (0.55, 0.60) | <0.001 | 0.55 (0.50, 0.59) | <0.001 |
| Pain diagnosisa | ||||
| Back pain | 0.70 (0.69, 0.72) | <0.001 | 0.56 (0.53, 0.59) | <0.001 |
| Neck pain | 0.77 (0.74, 0.79) | <0.001 | 0.71 (0.65, 0.78) | <0.001 |
| Migraine | 0.74 (0.71, 0.78) | <0.001 | 0.72 (0.64, 0.81) | <0.001 |
| Fibromyalgia | 0.69 (0.65, 0.74) | <0.001 | 0.53 (0.42, 0.65) | <0.001 |
| Osteoarthritis | 0.73 (0.71, 0.76) | <0.001 | 0.70 (0.62, 0.78) | <0.001 |
| Inflammatory joint disorder | 0.83 (0.81, 0.85) | <0.001 | 0.79 (0.74, 0.83) | <0.001 |
| Other medicationsa | ||||
| Opioid analgesics | 0.91 (0.90, 0.93) | <0.001 | 0.63 (0.60, 0.66) | <0.001 |
| Benzodiazepines | 1.06 (1.04, 1.08) | <0.001 | 0.98 (0.93, 1.03) | 0.519 |
| Antidepressants | 1.22 (1.20, 1.24) | <0.001 | 1.62 (1.56, 1.67) | <0.001 |
| Stimulants | 1.04 (1.00, 1.09) | 0.037 | 0.76 (0.69, 0.84) | <0.001 |
Source: T-MSIS.
Logistic regression models produced the AORs and 95% CIs. Individuals in the cohort were continuously enrolled in Medicaid for at least the duration of 90 days before the index OUD diagnosis and 180 days after the index OUD diagnosis. The logistic regression models also controlled for state of residence (not reported in the table).
ADHD, attention-deficit/hyperactivity disorder; AIAN, American Indian/Alaskan Native; OUD, opioid use disorder; PTSD, post-traumatic stress disorder; T-MSIS, Transformed Medicaid Statistical Information System.
The ref group for each OR under the comorbidity categories is those without the given comorbidity (e.g., the OR for alcohol use disorder measures the odds of buprenorphine/Vivitrol receipt for those with alcohol use disorder compared with that for those without alcohol use disorder).