title: Characteristics of methadone maintenance treatment patients prescribed opioid analgesics.
abstract: Opioid analgesic use and disorders have dramatically increased among the general American population and those receiving methadone maintenance treatment (MMT). Most research among MMT patients focuses on opioid analgesics misuse or disorders; few studies focus on MMT patients prescribed opioid analgesics. We describe demographic, clinical, and substance use characteristics of MMT patients prescribed opioid analgesics and compare them with MMT patients not prescribed opioid analgesics.
  
  
  
  We conducted a cross-sectional secondary data analysis using screening interviews from a parent study. From 2012 to 2015, we recruited adults from 3 MMT Bronx clinics. Questionnaire data included patterns of opioid analgesic use, substance use, comorbid illnesses, and demographic characteristics. Our main dependent variable was patients' report of currently taking prescribed opioid analgesics. To compare characteristics between MMT patients prescribed and not prescribed opioid analgesics, we conducted chi-square tests, t tests, and Mann-Whitney U tests.
  
  
  
  Of 611 MMT patients, most reported chronic pain (62.0%), hepatitis C virus (HCV) infection (52.1%), and current use of illicit substances (64.2%). Of the 29.8% who reported currently taking prescribed opioid analgesics, most misused their opioid analgesics (57.5%). Patients prescribed (versus not prescribed) opioid analgesics were more likely to report human immunodeficiency virus (HIV) infection (adjusted odds ratio [aOR] = 1.6, 95% confidence interval [CI]: 1.1-2.3) and chronic pain (aOR = 7.6, 95% CI: 4.6-12.6).
  
  
  
  Among MMT patients primarily in 3 Bronx clinics, nearly one third reported taking prescribed opioid analgesics. Compared with patients not prescribed opioid analgesics, those prescribed opioid analgesics were more likely to report chronic pain and HIV infection. However, between these patients, there was no difference in illicit substance use. These findings highlight the complexity of addressing chronic pain in MMT patients.
authors.affiliation: a Albert Einstein College of Medicine , Bronx , New York , USA.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Glenn
authors.affiliation: b The City College of New York, Sophie Davis School of Biomedical Education , New York , New York , USA.
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Sohler
authors.affiliation: a Albert Einstein College of Medicine , Bronx , New York , USA.|c Montefiore Medical Center, Division of General Internal Medicine , Bronx , New York , USA.
authors.forename: Joanna L
authors.initials: JL
authors.lastname: Starrels
authors.affiliation: a Albert Einstein College of Medicine , Bronx , New York , USA.
authors.forename: Jeronimo
authors.initials: J
authors.lastname: Maradiaga
authors.affiliation: a Albert Einstein College of Medicine , Bronx , New York , USA.
authors.forename: John J
authors.initials: JJ
authors.lastname: Jost
authors.affiliation: a Albert Einstein College of Medicine , Bronx , New York , USA.|c Montefiore Medical Center, Division of General Internal Medicine , Bronx , New York , USA.
authors.forename: Julia H
authors.initials: JH
authors.lastname: Arnsten
authors.affiliation: a Albert Einstein College of Medicine , Bronx , New York , USA.|c Montefiore Medical Center, Division of General Internal Medicine , Bronx , New York , USA.
authors.forename: Chinazo O
authors.initials: CO
authors.lastname: Cunningham
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use; D059350:Chronic Pain / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D055030:Drug Users / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D058850:Opiate Substitution Treatment; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone
keywords: HIV; methadone; opiate substitution therapy; opioid analgesics; pain; substance use