2025/12/04 by M. J. Stowe, Anna Conway, Frederick L. Altice +15 · 1 voice
Medicine · #Opioid Use Disorder Treatment #Pain Management and Opioid Use #Substance Abuse Treatment and Outcomes
paper · pdf · doi:10.1111/dar.70079
openalex publication_date 2025/12/04 · openalex created_date 2025/12/05 · openalex updated_date 2026/07/28
INTRODUCTION: Opioid agonist therapies (OAT) reduce adverse outcomes of illicit opioid use, with individual preferences potentially improving treatment outcomes. We explored preferences for OAT and associated factors in a national sample of people with opioid dependence. METHODS: This cross-sectional study recruited 400 participants (October 2020-April 2021) across Australia (excluding Tasmania) through snowball sampling. Participants completed an interviewer-administered questionnaire on sociodemographic and drug use characteristics. Multivariable logistic regression assessed factors associated with methadone preference (vs. buprenorphine). RESULTS: Among all participants (median age 45, 41% female, 87% ever received OAT), 92% (n = 366) indicated a preference for receiving OAT (vs. not receiving OAT) and 96% of those (n = 352) preferred a particular type of OAT. Among 366 with a stated preference, 61% (n = 216) preferred methadone and 39% (n = 136) preferred buprenorphine. Among those preferring buprenorphine (n = 136), 50% (n = 68) preferred buprenorphine ± naloxone and 50% (n = 68) preferred long-acting injectable buprenorphine. Independent correlates of preferring methadone included past month heroin use (aOR 1.78, 95% CI 1.06-3.00) and non-prescribed pharmaceutical opioid use (aOR 2.23, 95% CI 1.07, 4.95), and any prior receipt of methadone treatment (aOR 6.54, 95% CI 2.66, 17.91). Among those receiving OAT, a higher proportion of people currently receiving buprenorphine preferred their medication (61/66, 92%) compared to methadone recipients (180/235, 77%). DISCUSSION AND CONCLUSIONS: Nearly all participants preferred OAT, mostly reflecting prior experiences, underscoring the need for expanded access to OAT in Australia. Given the multiple stated preferences, OAT options should include a variety of treatment options aligned with patient preferences, including expanded take-home options.