{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T22:14:55Z","timestamp":1791756895587,"version":"4.3.4"},"reference-count":56,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,7,7]],"date-time":"2020-07-07T00:00:00Z","timestamp":1594080000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,7,7]],"date-time":"2020-07-07T00:00:00Z","timestamp":1594080000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100007217","name":"Health Services Research and Development","doi-asserted-by":"publisher","award":["CDA 18\u2010008 and"],"award-info":[{"award-number":["CDA 18\u2010008 and"]}],"id":[{"id":"10.13039\/100007217","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007217","name":"Health Services Research and Development","doi-asserted-by":"publisher","award":["RCS 19\u2010333"],"award-info":[{"award-number":["RCS 19\u2010333"]}],"id":[{"id":"10.13039\/100007217","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To understand the role of comorbid substance use disorders (SUDs), or polysubstance use, in the treatment of opioid use disorder (OUD), this study compared patients with OUD only to those with additional SUDs and examined association with OUD treatment receipt.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting and participants<\/jats:title>\n                    <jats:p>\n                      Retrospective national cohort study of Veterans diagnosed with OUD (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a065\u2009741) receiving care from the US Veterans Health Administration (VHA) in fiscal year (FY) 2017.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>\n                      Patient characteristics were compared among those diagnosed with OUD only versus those with one other SUD (OUD\u00a0+\u00a01 SUD) and with multiple SUDs (OUD\u00a0+\u00a0\u2265\u00a02 SUDs\n                      <jats:styled-content>)<\/jats:styled-content>\n                      . The study examined the relationship between comorbid SUDs and receipt of buprenorphine, methadone and SUD outpatient treatment during 1\u2010year follow\u2010up, adjusting for patient demographic characteristics and clinical conditions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      Among the 65\u2009741 Veterans with OUD in FY 2017, 41.2% had OUD only, 22.9% had OUD\u00a0+\u00a01 SUD and 35.9% had OUD\u00a0+\u00a0\u2265\u00a02 SUDs. Common comorbid SUDs included alcohol use disorder (41.3%), cocaine\/stimulant use disorder (30.0%) and cannabis use disorder (22.4%). Adjusting for patient characteristics, patients with OUD\u00a0+\u00a01 SUD [adjusted odds ratio (aOR)\u00a0=\u00a00.87, 95% confidence interval (CI)\u00a0=\u00a00.82\u20130.93] and patients with OUD\u00a0+\u2265\u00a0\n                      <jats:styled-content>2\u00a0SUDs<\/jats:styled-content>\n                      (aOR\u00a0=\u00a00.65, 95% CI\u00a0=\u00a00.61\u20130.69) had lower odds of receiving buprenorphine compared with OUD only patients. There were also lower odds of receiving methadone for patients with OUD\u00a0+\u00a01 SUD (aOR\u00a0=\u00a00.91, 95% CI\u00a0=\u00a00.86\u20130.97)and for those with OUD\u00a0+\u00a0\n                      <jats:styled-content>\u22652\u00a0SUDs<\/jats:styled-content>\n                      (aOR\u00a0=\u00a00.79, 95% CI\u00a0=\u00a00.74\u20130.84). Patients with OUD\u00a0+\u00a01 SUD (aOR\u00a0=\u00a01.85, 95% CI\u00a0=\u00a01.77\u20131.93) and patients with OUD\u00a0+\u00a0\n                      <jats:styled-content>\u22652\u00a0SUDs<\/jats:styled-content>\n                      (aOR\u00a0=\u00a03.25, 95% CI\u00a0=\u00a03.103.41) were much more likely to have a SUD clinic visit.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The majority of Veterans in the US Veterans Health Administration diagnosed with opioid use disorder appeared to have at least one comorbid substance use disorder and many have multiple substance use disorders. Despite the higher likelihood of a substance use disorder clinic visit, having a non\u2010opioid substance use disorder is associated with lower likelihood of buprenorphine treatment, suggesting the importance of addressing polysubstance use within efforts to expand treatment for opioid use disorder.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.15116","type":"journal-article","created":{"date-parts":[[2020,5,19]],"date-time":"2020-05-19T17:38:47Z","timestamp":1589909927000},"page":"96-104","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":94,"title":["Polysubstance use and association with opioid use disorder treatment in the US Veterans Health Administration"],"prefix":"10.1111","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2765-7814","authenticated-orcid":false,"given":"Lewei A.","family":"Lin","sequence":"first","affiliation":[{"name":"Center for Clinical Management Research (CCMR) VA Ann Arbor Healthcare System  Ann Arbor MI USA"},{"name":"Addiction Center, Department of Psychiatry University of Michigan  Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy S. B.","family":"Bohnert","sequence":"additional","affiliation":[{"name":"Center for Clinical Management Research (CCMR) VA Ann Arbor Healthcare System  Ann Arbor MI USA"},{"name":"Department of Anesthesiology University of Michigan  Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederic C.","family":"Blow","sequence":"additional","affiliation":[{"name":"Center for Clinical Management Research (CCMR) VA Ann Arbor Healthcare System  Ann Arbor MI USA"},{"name":"Addiction Center, Department of Psychiatry University of Michigan  Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam J.","family":"Gordon","sequence":"additional","affiliation":[{"name":"Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine University of Utah School of Medicine  Salt Lake City UT USA"},{"name":"Informatics, Decision\u2010Enhancement, and Analytic Sciences Center VA Salt Lake City Health Care System  Salt Lake City UT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalinda V.","family":"Ignacio","sequence":"additional","affiliation":[{"name":"Center for Clinical Management Research (CCMR) VA Ann Arbor Healthcare System  Ann Arbor MI USA"},{"name":"Addiction Center, Department of Psychiatry University of Michigan  Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Myra","family":"Kim","sequence":"additional","affiliation":[{"name":"Center for Clinical Management Research (CCMR) VA Ann Arbor Healthcare System  Ann Arbor MI USA"},{"name":"Consulting for Statistics, Computing and Analytics Research (CSCAR) University of Michigan  Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A.","family":"Ilgen","sequence":"additional","affiliation":[{"name":"Center for Clinical Management Research (CCMR) VA Ann Arbor Healthcare System  Ann Arbor MI USA"},{"name":"Addiction Center, Department of Psychiatry University of Michigan  Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,7,7]]},"reference":[{"key":"e_1_2_6_2_1","article-title":"Drug and opioid\u2010involved overdose deaths \u2014 United States, 2013\u20132017","author":"Scholl L","journal-title":"Morb Mort Wkly Rep"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.31027\/ODPRN.2017.01"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.12617"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6712a1"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2019.03.014"},{"key":"e_1_2_6_7_1","first-page":"1","article-title":"Drugs Most frequently involved in drug overdose deaths: United States, 2011\u20132016","volume":"67","author":"Hedegaard H.","year":"2018","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2011.10101476"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2015.06.020"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2006.07.009"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2019.01.031"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.13339"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000731"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.0001"},{"key":"e_1_2_6_15_1","article-title":"Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence","author":"Mattick R. 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Rockville MD: Substance Abuse and Mental Health Services Administration; 2013 [cited2019Sep 30]. 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