BACKGROUND: Successful treatment of patients with opioid use disorder (OUD) is an important step in addressing the current opioid epidemic. Recent U.S. surveys describe characteristics and treatments of individuals with self-reported problematic drug use, but no research has examined how these individuals differ from diagnosed OUD patients.
OBJECTIVE: Compare characteristics of real-world diagnosed OUD populations and populations estimated from nationally-representative surveys. Methods: Patients with ≥1 claim with an OUD diagnosis code (earliest=index) and ≥6 months pre- and post-index continuous enrollment were selected from administrative claims in the 2008-2014 MarketScan Commercial and Medicaid Databases. Patient characteristics were measured pre-index and OUD treatment post-index, and discussed in the context of survey results.
RESULTS: Study-eligible OUD patients (N= 103,768 commercially-insured, 50,552 Medicaid) were mean age 36. Males predominated the commercial (58%), but not the Medicaid sample (36%). Pre-index comorbidities included depressive disorders (26.9%), alcohol use disorder (7.5%), and other (non-opioid or alcohol) substance use disorders (16.5%). Psychiatric medication use was common; 43% of patients had claim(s) for antidepressants, 29.1% benzodiazepines, 19.2% non-benzodiazepines sedative/hypnotics, and 12.7% antipsychotics. Two-thirds received psychosocial or medication-assisted treatment. Survey research similarly found other substance abuse disorders and psychiatric comorbidity were associated with self-reported problematic drug use, but treatment rates were much lower.
CONCLUSIONS: OUD patients who come to the attention of clinicians share some characteristics with the overall population self-reporting problematic drug use via survey. Underrepresented groups may be patients needing additional supports to link to diagnosis and treatment, an important first step in the treatment trajectory.
