{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T10:47:54Z","timestamp":1785754074058,"version":"3.56.0"},"reference-count":41,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["1P30AI094189"],"award-info":[{"award-number":["1P30AI094189"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01\u2010DA\u2010057673"],"award-info":[{"award-number":["R01\u2010DA\u2010057673"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["U01\u2010DA\u2010036297"],"award-info":[{"award-number":["U01\u2010DA\u2010036297"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>In a policy environment with constrained access to the medications for opioid use disorder (MOUD), we examined the prevalence and correlates of extra\u2010medical use of these medications among individuals already prescribed MOUD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Among 641 adults in Baltimore participating in the ALIVE cohort study, who self\u2010reported buprenorphine or methadone treatment, we estimated the prevalence of using these same medications outside a formal treatment context (\u201cextra\u2010medical MOUD\u201d). Using logistic regression with generalised estimating equations to account for clustering within individuals, we assess behavioural, sociodemographic, and clinical correlates of extra\u2010medical MOUD use in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across 1325 visits in January 2023\u2013December 2024 (73% aged \u2265\u200950\u2009years, 68% Black, 64% male), 129 (10%) reported use of extra\u2010medical MOUD. Use of multiple substances (OR 6.05 [95% CI 3.96, 9.23]), injection drug use (6.79 [4.30, 10.70]), any withdrawal sickness (5.51 [3.62, 8.38]) and depressive symptoms (3.90 [2.64, 5.76]) were significantly associated with extra\u2010medical MOUD use. Those engaged in methadone treatment \u2265\u20096\u2009months had significantly lower odds of extra\u2010medical use (adjusted OR [aOR]: 0.42 [0.22, 0.80]), compared with those newly engaged. By contrast, prescribed buprenorphine dose, but not duration of engagement, was associated with extra\u2010medical use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Conclusions<\/jats:title>\n                    <jats:p>Among adults receiving legally prescribed or dispensed buprenorphine or methadone, extra\u2010medical use of these same medications was reported at one in every 10 visits. Those with heightened vulnerability to drug\u2010related harms were most likely to use extra\u2010medical MOUD. Findings have implications for policies and practices restricting treatment access.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dar.70204","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T11:20:18Z","timestamp":1782818418000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Concurrent Use of Extra\u2010Medical Medication for Opioid Use Disorder Among Adults Prescribed Methadone or Buprenorphine: A Cohort Study of Urban Adults Who Have Injected Drugs"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0655-0583","authenticated-orcid":false,"given":"Kyle J.","family":"Moon","sequence":"first","affiliation":[{"name":"Department of Mental Health Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Becky L.","family":"Genberg","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacquie","family":"Astemborski","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"German","sequence":"additional","affiliation":[{"name":"Department of Health, Behavior, and Society Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory D.","family":"Kirk","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"},{"name":"Division of Infectious Diseases Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shruti H.","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth A.","family":"Feder","sequence":"additional","affiliation":[{"name":"Department of Mental Health Johns Hopkins Bloomberg School of Public Health  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1402780"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.14991"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofab289"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2007.08.004"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.20622"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.3821"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2022.103786"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.3711"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1468\u20100009.12602"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dadr.2022.100091"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dadr.2024.100255"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000436"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2013.08.008"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2012.05.025"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2019.06.019"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2018.09.007"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2016.08.002"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2012.10.003"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2020.108031"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.34540"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2023.7282"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2022.108832"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000001050"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/10826084.2021.1908360"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1080\/10826084.2023.2177972"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.15659"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/002204269102100406"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0955\u20103959(02)00007\u20105"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/1520\u20106629(198001)8:1<20::AID\u2010JCOP2290080105>3.0.CO;2\u2010Y"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2016.12.009"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000003511"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws412"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v015.i02"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(07)61602\u2010X"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360\u20100443.2007.01767.x"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2023.104120"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12954\u2010019\u20100301\u2010y"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2019.107574"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2015.04.010"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2022.108770"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.107958"}],"container-title":["Drug and Alcohol Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dar.70204","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dar.70204","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dar.70204","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T10:17:15Z","timestamp":1785752235000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dar.70204"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,30]]},"references-count":41,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/dar.70204"],"URL":"https:\/\/doi.org\/10.1111\/dar.70204","archive":["Portico"],"relation":{},"ISSN":["0959-5236","1465-3362"],"issn-type":[{"value":"0959-5236","type":"print"},{"value":"1465-3362","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,30]]},"assertion":[{"value":"2025-10-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70204"}}