Evidence map›Paper›PMID 40499684›Full record

ArticleJournal of substance use and addiction treatment2025

Association of state medicaid prescription cap policies with trajectories of buprenorphine use for opioid use disorder.

Patience M Dow, Miriam George, Landon D Hughes, Corinne Roma, Theresa I Shireman, Julie M Donohue, Lisa Peterson, Jaclyn M W Hughto

Abstract read
In one paragraph

Article in Journal of substance use and addiction treatment, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Patience M DowBrown University School of Public Health, Department of Health Services, Policy, and Practice, Providence, RI, USA. Electronic address: patience_dow@brown.edu.
Miriam GeorgeBrown University School of Public Health, Department of Health Services, Policy, and Practice, Providence, RI, USA.
Landon D HughesHarvard T. H. Chan School of Public Health, Department of Epidemiology, Boston, MA, USA; Harvard Pilgrim Health Care Institute, Department of Population Medicine, Boston, MA, USA.
Corinne RomaBrown University School of Public Health, Department of Health Services, Policy, and Practice, Providence, RI, USA.
Theresa I ShiremanBrown University School of Public Health, Department of Health Services, Policy, and Practice, Providence, RI, USA.
Julie M DonohueUniversity of Pittsburgh School of Public Health, Department of Health Policy and Management, Pittsburgh, PA, USA.
Lisa PetersonVICTA, Providence, RI, USA.
Jaclyn M W HughtoVICTA, Providence, RI, USA; Brown University School of Public Health, Departments of Behavioral and Social Sciences and Epidemiology, Providence, RI, USA.

Funding

Impact of Prescription Caps on Health Outcomes in People Infected with HIVR01MH122301 · NIMH · BROWN UNIVERSITY · PI GALARRAGA, OMAR, SHIREMAN, THERESA I. · 2020 to 2024
$3.7M
Impact of Medicaid Prescription Cap Policies on Treatment Outcomes for Opioid Use Disorder: A National Mixed Methods StudyR01DA057979 · NIDA · BROWN UNIVERSITY · PI Patience Moyo Dow, Jaclyn White Hughto · 2023 to 2026
$3.0M
NIDA NIH HHS R01 DA057979NIMH NIH HHS R01 MH122301
6 · The paper itself

Abstract

backgroundBuprenorphine and other medications for opioid use disorder (OUD) can reduce opioid-related morbidity and mortality. It is unknown whether state Medicaid prescription cap policies that restrict the monthly number of covered prescription fills affect the duration of buprenorphine use.

objectiveTo identify trajectories of buprenorphine use and determine the association of caps with trajectory group membership among individuals with OUD.

methodsUsing 10 states' Medicaid claims data from 2010 to 2015, we employed group-based trajectory models to identify patterns of buprenorphine fills over 12 months. We conducted multinomial logistic regression to estimate the association of cap policies with buprenorphine trajectory group membership, adjusting for individual- and state-level covariates.

resultsAmong 69,306 Medicaid enrollees with OUD who initiated buprenorphine, 16.9 % resided in states with caps. The mean age was 36.2 (SD = 9.8) years and 59.2 % were female. We identified five trajectories: consistent use (40.9 %), delayed discontinuation (14.5 %), early discontinuation (26.4 %), gradually declining use (9.5 %), and rebounding use (8.8 %). Caps were associated with greater risk of membership in the early discontinuation group (adjusted relative risk ratio = 1.47, 95%CI = 1.36,1.59, referent = consistent use). Younger age, male sex, Black race, Hispanic ethnicity, non-opioid substance use disorder, history of acute care utilization were also positively associated with early discontinuation.

conclusionsMedicaid cap policies were associated with increased likelihood of early discontinuation and other trajectories of inconsistent buprenorphine use relative to states without these policies. Medicaid's prominence as a payer for OUD treatment and 12 states' continued implementation of caps warrant safeguards to ensure cap policies do not undermine buprenorphine access.

Indexed as

BuprenorphineMedicaidNarcotic AntagonistsOpiate Substitution TreatmentOpioid-Related DisordersAdultFemaleHumansMaleMiddle AgedUnited StatesBuprenorphineNarcotic AntagonistsBuprenorphineGroup-based trajectory modelingMedicaidOpioid use disorder

Identifiers

PMID40499684
PMCPMC12257975

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.