Differences in prescribing patterns of opioid dependence drugs among patients with primary alcohol use problems and opioid use disorders within New York State by social determinant factors, 2005-2018

Background: The increase in alcohol use problems and opioid use disorder (OUD) highlights the need for research on effective medication treatments for patients with dual diagnoses. Objectives: This study analyzed trends and social disparities in prescribing OUD medications for patients who initially had alcohol use problems and later received their first OUD diagnosis. Methods: This study used merged data from the New York State Office of Addiction Services and Supports and the Medicaid to analyze individuals aged 18 years and older who initially had primary alcohol use problems and later had OUD for the first time between 2005 and 2018. It examined the rates of new buprenorphine and naltrexone prescriptions across various demographic and socioeconomic groups. Results: Among 27,029 clients, the average rate of new buprenorphine was 64.23 per 1000 clients (95% CI 61.30–67.15), with upward trends. The 18-35 age group had the highest buprenorphine utilization (111.48 per 1000 clients) and highest increase rates compared with other age groups. The white non-Hispanic group had the highest rates of buprenorphine (119.23 per 1000 clients) and showed larger increase over time compared with other race or ethnicity groups. Disabled patients showed slower increasing rates of buprenorphine than other groups. Upward trends were observed in naltrexone. All observed differences were statistically significant (P < 0.05). Conclusions: Trends showed increased use of OUD medications, with varying rates of buprenorphine utilization across different ages, races, and employment statuses. Despite this, the rates of receiving new buprenorphine remained low, suggesting a need for innovative methods to expand access to treatments.