Examining the Role of Gender in the Association between Medication Assisted Treatment and Treatment Completion Among Emerging Adults

Background and Purpose: Emerging adults aged 18 to 29 with opioid use disorders (OUD) have the lowest treatment engagement and retention compared to any other age group. Understanding effective factors to complete the treatment process among emerging adults who seek treatment is imperative in effectively addressing OUD. Emerging adults are in a unique biopsychosocial developmental phase and the receipt of medication assisted treatment (MAT) for emerging adults with OUD needs further investigation. In this study, we examined factors associated with treatment completion among emerging adults with OUD in outpatient settings. We also examined the role gender plays in receiving MAT and completing treatment.

Method: Data is from the 2019 Treatment Episode Data Set Discharges (TEDS-D), including all emerging adults with opiate use disorders seeking substance use treatment in outpatient treatment settings (N = 28,515). Measures include dichotomous indicators of treatment completion (vs. drop out), receipt of MAT, co-occurring mental health or substance use disorders, and prior treatment episodes. Additional measures in the TEDS-D include age, gender (male/female), race/ethnicity, and education. A multivariate logistic regression examined associations with treatment completion and the variables described above.

Results: About 42% of the sample completed their treatment. A multivariate logistic regression model showed that the odds of treatment completion was higher among individuals between ages 21-24 (OR = 1.27, p<.01) and 25-29 (OR = 1.31, p < .01) compared to individuals between ages 18-20. Individuals who were Black/African American had lower odds of completion compared to White non-Hispanic individuals (OR = 0.69, p <.01). Individuals with a college or high school education degree had higher odds than those with no high school degree or GED (OR = 1.27, p < .01). Women showed lower odds in completing treatment compared to men (OR = .92, p < .01). Individuals who did not received MAT (OR = 1.99, p < .01) showed higher odds in completing treatment. Results also show that individuals with a history of prior treatment (OR = 1.18, p < .01) had higher odds of completing treatment compared with those with no history of treatment. Persons who did not have a co-occurring mental health or substance use disorder had lower odds of completing treatment (OR = .98, p< .01). The relationship between treatment completion and receiving MAT was moderated by gender. Men who received MAT had higher odds of treatment completion compared to women who received MAT. Men and Women who did not receive MAT had no difference in odds of completion.

Conclusions and Implications: While research shows that MAT can assist in successfully treating OUD, this study highlights that the differences that MAT may play in treatment completion among emerging adults who are men and women. Researchers should focus attention on other associations that impact the effect of MAT on the successful opioid treatment process. Also, further research should examine within-group differences that impact treatment completion and the medication interventions for this population, including more broad constructions of gender, gender identity, and sexual preference.