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The goal of the present paper was to inform treatments for opioid use disorder (OUD) by exploring individual factors for each sex that are most strongly associated with opioid use following treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Secondary analysis of Global Appraisal of Individual Needs (GAIN) database with follow\u2010ups at 3, 6 and 12\u00a0months post\u2010OUD treatment discharge, exploring demographic, psychological and behavioral variables that predict post\u2010treatment opioid use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>One hundred and thity\u2010seven treatment sites across the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      Adolescents (26.9%), young adults (40.8%) and adults (32.3%) in treatment for OUD. The sample (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a01,126) was 54.9% male, 66.1% white, 20% Hispanic, 9.8% multi\u2010race\/ethnicity, 2.8% African American and 1.3% other.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurement<\/jats:title>\n                    <jats:p>Primary outcome was latency to opioid use over 1\u00a0year following treatment admission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For women, regularized Cox regression indicated that greater withdrawal symptoms [hazard ratio (HR)\u00a0=\u00a01.31], younger age (HR\u00a0=\u00a00.88), prior substance use disorder (SUD) treatment (HR\u00a0=\u00a01.11) and treatment resistance (HR\u00a0=\u00a01.11) presented the largest hazard for post\u2010treatment opioid use, while a random survival forest identified and ranked substance use problems [variable importance (VI)\u00a0=\u00a00.007], criminal justice involvement (VI\u00a0=\u00a00.006), younger age (VI\u00a0=\u00a00.005) and greater withdrawal symptoms (VI\u00a0=\u00a00.004) as the greatest risk factors. For men, Cox regression indicated greater conduct disorder symptoms (HR\u00a0=\u00a01.34), younger age (HR\u00a0=\u00a00.76) and multiple SUDs (HR\u00a0=\u00a01.27) were most strongly associated with post\u2010treatment opioid use, while a random survival forests ranked younger age (VI\u00a0=\u00a00.023), greater conduct disorder symptoms (VI\u00a0=\u00a00.010), having multiple substance use disorders (VI\u00a0=\u00a00.010) and criminal justice involvement (VI\u00a0=\u00a00.006) as the greatest risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Risk factors for relapse to opioid use following opioid use disorder treatment appear to be, for women, greater substance use problems and withdrawal symptoms and, for men, younger age and histories of conduct disorder and multiple substance use disorder.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.15396","type":"journal-article","created":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T22:45:37Z","timestamp":1610059537000},"page":"2116-2126","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["Sex differences in factors predicting post\u2010treatment opioid use"],"prefix":"10.1111","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6108-4936","authenticated-orcid":false,"given":"Jordan P.","family":"Davis","sequence":"first","affiliation":[{"name":"Suzanne Dworak\u2010Peck School of Social Work, USC Center for Artificial Intelligence in Society, USC Center for Mindfulness Science, USC Institute for Addiction Science, University of Southern California  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0619-7209","authenticated-orcid":false,"given":"David","family":"Eddie","sequence":"additional","affiliation":[{"name":"Recovery Research Institute, Center for Addiction Medicine Massachusetts General Hospital, Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Prindle","sequence":"additional","affiliation":[{"name":"University of Southern California  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily R.","family":"Dworkin","sequence":"additional","affiliation":[{"name":"University of Washington School of Medicine  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0976-6195","authenticated-orcid":false,"given":"Nina C.","family":"Christie","sequence":"additional","affiliation":[{"name":"Department of Psychology and the USC Brain and Creativity Institute University of Southern California  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaddy","family":"Saba","sequence":"additional","affiliation":[{"name":"Suzanne Dworak\u2010Peck School of Social Work, USC Center for Artificial Intelligence in Society, USC Center for Mindfulness Science, USC Institute for Addiction Science, University of Southern California  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham T.","family":"DiGuiseppi","sequence":"additional","affiliation":[{"name":"Suzanne Dworak\u2010Peck School of Social Work, USC Center for Artificial Intelligence in Society, USC Center for Mindfulness Science, USC Institute for Addiction Science, University of Southern California  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Clapp","sequence":"additional","affiliation":[{"name":"Suzanne Dworak\u2010Peck School of Social Work, USC Keck School of Medicine, USC Institute for Addiction Science University of Southern California  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John F.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Recovery Research Institute, Center for Addiction Medicine Massachusetts General Hospital, Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,1,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.12551"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000625"},{"key":"e_1_2_9_4_1","unstructured":"2017 Drug Overdose Death Rates. 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