Factors Associated With Preferences for Opioid Agonist Therapies Among People Dependent on Opioids
Year: 2025
Type: article
Study design: Observational Study
Abstract: INTRODUCTION: Opioid agonist therapies (OAT) reduce adverse outcomes of illicit opioid use, with individual preferences potentially improving treatment outcomes. We explored preferences for OAT and associated factors in a national sample of people with opioid dependence. METHODS: This cross-sectional study recruited 400 participants (October 2020-April 2021) across Australia (excluding Tasmania) through snowball sampling. Participants completed an interviewer-administered questionnaire on sociodemographic and drug use characteristics. Multivariable logistic regression assessed factors associated with methadone preference (vs. buprenorphine). RESULTS: Among all participants (median age 45, 41% female, 87% ever received OAT), 92% (n = 366) indicated a preference for receiving OAT (vs. not receiving OAT) and 96% of those (n = 352) preferred a particular type of OAT. Among 366 with a stated preference, 61% (n = 216) preferred methadone and 39% (n = 136) preferred buprenorphine. Among those preferring buprenorphine (n = 136), 50% (n = 68) preferred buprenorphine ± naloxone and 50% (n = 68) preferred long-acting injectable buprenorphine. Independent correlates of preferring methadone included past month heroin use (aOR 1.78, 95% CI 1.06-3.00) and non-prescribed pharmaceutical opioid use (aOR 2.23, 95% CI 1.07, 4.95), and any prior receipt of methadone treatment (aOR 6.54, 95% CI 2.66, 17.91). Among those receiving OAT, a higher proportion of people currently receiving buprenorphine preferred their medication (61/66, 92%) compared to methadone recipients (180/235, 77%). DISCUSSION AND CONCLUSIONS: Nearly all participants preferred OAT, mostly reflecting prior experiences, underscoring the need for expanded access to OAT in Australia. Given the multiple stated preferences, OAT options should include a variety of treatment options aligned with patient preferences, including expanded take-home options.
Source: Drug and Alcohol Review
DOI: 10.1111/dar.70079
Authors: M. J. Stowe, Anna Conway, Frederick L. Altice, Samantha Colledge‐Frisby, Phillip Read, Mark Montebello, Gilbert Whitton, Jeremy Hayllar, Mark Daglish, Victoria Cock, Michael Christmass, Sione Crawford, Charles Henderson, Gregory J. Dore, Chris Gough, Michael Farrell, Louisa Degenhardt, Jason Grebely
Institutions: UNSW Sydney, Kirby Institute, Yale University, Curtin University, National Drug and Alcohol Research Centre, National Drug Research Institute, South Eastern Sydney Local Health District, The University of Sydney, Northern Sydney Local Health District, South Western Sydney Local Health District, Metro North Hospital and Health Service, Next Step Drug and Alcohol Services
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,430
Awards: Improving the health of people with problematic drug use: hepatitis C and drug dependence, G1513324279, Integrating Addiction Treatment and HIV Services into Primary Care Clinics in Ukraine, Improving health outcomes for people who inject drugs: hepatitis C and drug dependence, Strategies to facilitate elimination of hepatitis C infection among people who inject drugs, Intervention of HIV, Drug Use and the Criminal Justice System in Malaysia, Addiction, HIV and Tuberculosis in Malaysian Criminal Justice Settings, Expanding Medication Assisted Therapy in Ukraine (ExMAT), Enhancing hepatitis C testing, treatment, and prevention to facilitate elimination, G8488284102, Improving Knowledge and Interventions to reduce and prevent substance use related harms, Prison Interventions and HIV Prevention Collaboration, Expanding Medication Assisted Therapies in Central Asia
OpenAlex ID: W4417025789