Buprenorphine discontinuation and utilization of psychosocial services: a national study in the Veterans Health Administration

Table 3 Associations between service use and buprenorphine discontinuation within 18 months

Service	Minimally adjusted	Fully adjusted
	HR (95% CI)	HR (95% CI)
Substance use disorder psychotherapy	0.90 (0.86, 0.95)	0.82 (0.77, 0.87)
Primary care-based mental health	0.95 (0.90, 1.00)	0.93 (0.88, 0.99)
Primary care	0.97 (0.93, 1.01)	0.94 (0.90, 0.98)
Pain services	1.00 (0.94, 1.06)	0.96 (0.91, 1.02)
Mental health clinic	1.14 (1.08, 1.20)	1.05 (1.00, 1.11)
Social work	1.14 (1.09, 1.20)	1.07 (1.03, 1.12)
Clinical pharmacy	1.15 (1.09, 1.20)	1.07 (1.02, 1.12)
Post-traumatic stress disorder treatment	1.19 (1.12, 1.27)	1.09 (1.02, 1.15)
Criminal justice outreach	1.26 (1.18, 1.35)	1.12 (1.04, 1.20)
Vocational services	1.30 (1.21, 1.40)	1.09 (1.00, 1.19)
Recreational or occupational therapy	1.38 (1.29, 1.48)	1.13 (1.06, 1.21)
Chaplain	1.39 (1.28, 1.51)	1.13 (1.05, 1.22)
Residential treatment	1.50 (1.37, 1.65)	1.26 (1.15, 1.39)

Bolding indicates statistically significant fully adjusted HRs after false discovery rate correction. Minimally adjusted models include each lagged service predictor separately, fully adjusted model includes all lagged service predictors simultaneously. All models adjust for age, gender, race, lagged ED visits, and lagged receipt of buprenorphine from multiple facilities. Note. HR = Hazard Ratio. 95% CI = 95% Confidence Interval. ED = emergency department

ISSN: 1940-0640