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dc.contributor.authorHochheimer, Martin
dc.date.accessioned2022-06-17T11:53:18Z
dc.date.available2022-06-17T11:53:18Z
dc.date.issued2022
dc.identifier.urihttp://hdl.handle.net/10713/19195
dc.descriptionUniversity of Maryland, Baltimore. Social Work. Ph.D. 2022.en_US
dc.description.abstractMedications for the treatment of opioid use disorder (MOUDs) are considered the gold standard form of treatment for this condition. There are two forms of MOUD treatment, agonist, and antagonist. Agonist treatment has the medical system provide people with opioid use disorder methadone or buprenorphine which are long lasting opioids that do not produce a euphoric reaction with the goal of alleviating cravings and mitigating illicit use of opioids. Conversely, antagonist treatment blocks opioid absorption in the brain. Extended-release naltrexone (XR-NTX) is the most common antagonist treatment it is administered as a once-monthly injection. During the month after injection, patients who use opioids will not experience their effect and by negating the reward of opioid use the treatment discourages continued use. This study evaluated the effectiveness of buprenorphine and XR-NTX treatment on three characteristics: treatment retention, risk of opioid related acute care incidents, and changes in healthcare costs during treatment. Data from the Truven Health MarketScan® databases which records the date, type of interaction, and cost of every interaction that a person insured privately with one of over 250 insurance providers has with the healthcare system was used to identify a sample of approximately 30,000 people who were treated with buprenorphine or and 617 who were treated with XR-NTX for opioid use disorder. Treatment episodes were constructed based on filled prescription information and a frailty model survival analysis was fit both to a matched sample and the whole sample to length of treatment for each medication. The risk of acute care incidents was evaluated using a generalized estimating equation, and healthcare costs were evaluated using fixed-effects regression models. The study found that there are no significant differences in treatment retention between the MOUDS. Treatment with either medication was associated with an approximately 10% reduction, per day in treatment, of the odds of experiencing an acute care incident during one month. Healthcare costs increased while people were in treatment, with either MOUD, between approximately 0.85% and 1.5% for both opioid related and non-opioid related services.en_US
dc.language.isoen_USen_US
dc.subject.meshNaltrexone--therapeutic useen_US
dc.subject.meshOpioid-Related Disordersen_US
dc.subject.meshBuprenorphineen_US
dc.subject.meshHealth Care Costsen_US
dc.titleAn Evaluation of the Effectiveness of Extended-Release Naltrexoneen_US
dc.typedissertationen_US
dc.date.updated2022-06-10T22:13:29Z
dc.language.rfc3066en
dc.contributor.advisorSacco, Paul
dc.contributor.advisorUnick, George Jay
dc.contributor.orcid0000-0001-6644-4841


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