(R) Age and Medication Assisted Treatment Among Veterans Seeking Treatment for Opioid Use Disorder at Non-Veterans Health Administration Facilities.

Joseph Pickard; Carissa van den Berk-Clark; Monica M Matthieu

doi:10.1093/milmed/usab242

(R) Age and Medication Assisted Treatment Among Veterans Seeking Treatment for Opioid Use Disorder at Non-Veterans Health Administration Facilities.

Joseph Pickard, Carissa van den Berk-Clark, Monica M Matthieu

University of Missouri-St. Louis

Research output: Contribution to journal › Article › peer-review

Abstract

<div class="line" id="line-11"> Background</div><div class="line" id="line-73"> Medication-assisted treatment has been shown to be effective in treating opioid use disorder among both older adults and veterans of U.S. Armed Forces. However, limited evidence exists on MAT’s differential effect on treatment completion across age groups. This study aims to ascertain the role of MAT and age in treatment completion among veterans seeking treatment in non–Department of Veterans Affairs healthcare facilities for opioid use disorder.</div><div class="line" id="line-75"> Methods</div><div class="line" id="line-77"> We used the Treatment Episode Data Set—Discharges (TEDS-D; 2006-2017) to examine trends in treatment and MAT usage over time and TEDS-2017 to determine the role of age and MAT in treatment completion. We examined a subset of those who self-identified as veterans and who sought treatment for an opioid use disorder.</div><div class="line" id="line-79"> Results</div><div class="line" id="line-81"> Veterans presented in treatment more often as heroin users than prescription opioid users, and older veterans were more likely to get MAT than younger veterans. We found that before propensity score matching, MAT initially appeared to be associated with a lower likelihood of treatment completion in inpatient ( <span style="font-family: inherit; font-size: 0.875rem;"> &NoBreak; </span> <span style="font-family: MathJax_Math-italic; font-size: inherit;"> β </span> <span style="font-family: inherit; font-size: inherit;"> β </span>  = −1.47, 95% CI −1.56 to −1.39) and outpatient ( <span style="font-family: inherit; font-size: 0.875rem;"> &NoBreak; </span> <span style="font-family: MathJax_Math-italic; font-size: inherit;"> β </span> <span style="font-family: inherit; font-size: inherit;"> β </span>  = −1.40, 95% CI −2.21 to −0.58) settings, and age (50+ years) appeared to mediate the effect of MAT on treatment completion ( <span style="font-family: inherit; font-size: 0.875rem;"> &NoBreak; </span> <span style="font-family: MathJax_Math-italic; font-size: inherit;"> β </span> <span style="font-family: inherit; font-size: inherit;"> β </span>  = −0.54, 95% CI −0.87 to −0.21). After matching, older veterans were more likely to complete substance use disorder treatment ( <span style="font-family: inherit; font-size: 0.875rem;"> &NoBreak; </span> <span style="font-family: MathJax_Math-italic; font-size: inherit;"> β </span> <span style="font-family: inherit; font-size: inherit;"> β </span>  = 0.21, 95% CI 0.01-0.42), while age no longer mediated the effect of MAT, and MAT had a significant positive impact on treatment completion in detox settings ( <span style="font-family: inherit; font-size: 0.875rem;"> &NoBreak; </span> <span style="font-family: MathJax_Math-italic; font-size: inherit;"> β </span> <span style="font-family: inherit; font-size: inherit;"> β </span>  = 1.36, 95% CI 1.15-1.50) and inpatient settings ( <span style="font-family: inherit; font-size: 0.875rem;"> &NoBreak; </span> <span style="font-family: MathJax_Math-italic; font-size: inherit;"> β </span> <span style="font-family: inherit; font-size: inherit;"> β </span>  = 1.54, 95% CI 1.37 -1.71).</div><div class="line" id="line-407"> Conclusion</div><div class="line" id="line-409"> The results show that age plays an important role in outpatient treatment completion, while MAT plays an important role in inpatient treatment completion. Implications for veterans are discussed.</div>

Original language	American English
Journal	Military Medicine
Volume	187
DOIs	https://doi.org/10.1093/milmed/usab242
State	Published - 2022

Keywords

datasets
detoxification therapy
heroin
inpatients
older adult
opioid use disorders
opioids
outpatients
veterans

Disciplines

Social Work

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10.1093/milmed/usab242License: Unspecified

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@article{fc1423fc8f8a4c19a2bf0c15ec18cce0,

title = "(R) Age and Medication Assisted Treatment Among Veterans Seeking Treatment for Opioid Use Disorder at Non-Veterans Health Administration Facilities.",

abstract = " Background Medication-assisted treatment has been shown to be effective in treating opioid use disorder among both older adults and veterans of U.S. Armed Forces. However, limited evidence exists on MAT’s differential effect on treatment completion across age groups. This study aims to ascertain the role of MAT and age in treatment completion among veterans seeking treatment in non–Department of Veterans Affairs healthcare facilities for opioid use disorder. Methods We used the Treatment Episode Data Set—Discharges (TEDS-D; 2006-2017) to examine trends in treatment and MAT usage over time and TEDS-2017 to determine the role of age and MAT in treatment completion. We examined a subset of those who self-identified as veterans and who sought treatment for an opioid use disorder. Results Veterans presented in treatment more often as heroin users than prescription opioid users, and older veterans were more likely to get MAT than younger veterans. We found that before propensity score matching, MAT initially appeared to be associated with a lower likelihood of treatment completion in inpatient ( &NoBreak; β β  = −1.47, 95% CI −1.56 to −1.39) and outpatient ( &NoBreak; β β  = −1.40, 95% CI −2.21 to −0.58) settings, and age (50+ years) appeared to mediate the effect of MAT on treatment completion ( &NoBreak; β β  = −0.54, 95% CI −0.87 to −0.21). After matching, older veterans were more likely to complete substance use disorder treatment ( &NoBreak; β β  = 0.21, 95% CI 0.01-0.42), while age no longer mediated the effect of MAT, and MAT had a significant positive impact on treatment completion in detox settings ( &NoBreak; β β  = 1.36, 95% CI 1.15-1.50) and inpatient settings ( &NoBreak; β β  = 1.54, 95% CI 1.37 -1.71). Conclusion The results show that age plays an important role in outpatient treatment completion, while MAT plays an important role in inpatient treatment completion. Implications for veterans are discussed.",

keywords = "datasets, detoxification therapy, heroin, inpatients, older adult, opioid use disorders, opioids, outpatients, veterans",

author = "Joseph Pickard and {van den Berk-Clark}, Carissa and Matthieu, {Monica M}",

note = "Widespread opioid use among military personnel, veterans, and the broader civilian population in the USA has long been a concern. Among veterans and service members, there are additional concerns about opioid use because of coexisting heavy alcohol use and PTSD.",

year = "2022",

doi = "10.1093/milmed/usab242",

language = "American English",

volume = "187",

journal = "Military Medicine",

}

TY - JOUR

T1 - (R) Age and Medication Assisted Treatment Among Veterans Seeking Treatment for Opioid Use Disorder at Non-Veterans Health Administration Facilities.

AU - Pickard, Joseph

AU - van den Berk-Clark, Carissa

AU - Matthieu, Monica M

N1 - Widespread opioid use among military personnel, veterans, and the broader civilian population in the USA has long been a concern. Among veterans and service members, there are additional concerns about opioid use because of coexisting heavy alcohol use and PTSD.

PY - 2022

Y1 - 2022

N2 - Background Medication-assisted treatment has been shown to be effective in treating opioid use disorder among both older adults and veterans of U.S. Armed Forces. However, limited evidence exists on MAT’s differential effect on treatment completion across age groups. This study aims to ascertain the role of MAT and age in treatment completion among veterans seeking treatment in non–Department of Veterans Affairs healthcare facilities for opioid use disorder. Methods We used the Treatment Episode Data Set—Discharges (TEDS-D; 2006-2017) to examine trends in treatment and MAT usage over time and TEDS-2017 to determine the role of age and MAT in treatment completion. We examined a subset of those who self-identified as veterans and who sought treatment for an opioid use disorder. Results Veterans presented in treatment more often as heroin users than prescription opioid users, and older veterans were more likely to get MAT than younger veterans. We found that before propensity score matching, MAT initially appeared to be associated with a lower likelihood of treatment completion in inpatient ( &NoBreak; β β  = −1.47, 95% CI −1.56 to −1.39) and outpatient ( &NoBreak; β β  = −1.40, 95% CI −2.21 to −0.58) settings, and age (50+ years) appeared to mediate the effect of MAT on treatment completion ( &NoBreak; β β  = −0.54, 95% CI −0.87 to −0.21). After matching, older veterans were more likely to complete substance use disorder treatment ( &NoBreak; β β  = 0.21, 95% CI 0.01-0.42), while age no longer mediated the effect of MAT, and MAT had a significant positive impact on treatment completion in detox settings ( &NoBreak; β β  = 1.36, 95% CI 1.15-1.50) and inpatient settings ( &NoBreak; β β  = 1.54, 95% CI 1.37 -1.71). Conclusion The results show that age plays an important role in outpatient treatment completion, while MAT plays an important role in inpatient treatment completion. Implications for veterans are discussed.

AB - Background Medication-assisted treatment has been shown to be effective in treating opioid use disorder among both older adults and veterans of U.S. Armed Forces. However, limited evidence exists on MAT’s differential effect on treatment completion across age groups. This study aims to ascertain the role of MAT and age in treatment completion among veterans seeking treatment in non–Department of Veterans Affairs healthcare facilities for opioid use disorder. Methods We used the Treatment Episode Data Set—Discharges (TEDS-D; 2006-2017) to examine trends in treatment and MAT usage over time and TEDS-2017 to determine the role of age and MAT in treatment completion. We examined a subset of those who self-identified as veterans and who sought treatment for an opioid use disorder. Results Veterans presented in treatment more often as heroin users than prescription opioid users, and older veterans were more likely to get MAT than younger veterans. We found that before propensity score matching, MAT initially appeared to be associated with a lower likelihood of treatment completion in inpatient ( &NoBreak; β β  = −1.47, 95% CI −1.56 to −1.39) and outpatient ( &NoBreak; β β  = −1.40, 95% CI −2.21 to −0.58) settings, and age (50+ years) appeared to mediate the effect of MAT on treatment completion ( &NoBreak; β β  = −0.54, 95% CI −0.87 to −0.21). After matching, older veterans were more likely to complete substance use disorder treatment ( &NoBreak; β β  = 0.21, 95% CI 0.01-0.42), while age no longer mediated the effect of MAT, and MAT had a significant positive impact on treatment completion in detox settings ( &NoBreak; β β  = 1.36, 95% CI 1.15-1.50) and inpatient settings ( &NoBreak; β β  = 1.54, 95% CI 1.37 -1.71). Conclusion The results show that age plays an important role in outpatient treatment completion, while MAT plays an important role in inpatient treatment completion. Implications for veterans are discussed.

KW - datasets

KW - detoxification therapy

KW - heroin

KW - inpatients

KW - older adult

KW - opioid use disorders

KW - opioids

KW - outpatients

KW - veterans

UR - https://doi.org/10.1093/milmed/usab242

U2 - 10.1093/milmed/usab242

DO - 10.1093/milmed/usab242

M3 - Article

VL - 187

JO - Military Medicine

JF - Military Medicine

ER -

(R) Age and Medication Assisted Treatment Among Veterans Seeking Treatment for Opioid Use Disorder at Non-Veterans Health Administration Facilities.

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