Multivariable log-binomial analyses of the association between cooccurring SUD and medication initiation during the first treatment episode while controlling for age, Medicaid status, and sex are shown in Table 2. The presence of any cooccurring SUD was associated with decreased likelihood of buprenorphine treatment at time of OUD treatment initiation (risk ratio [RR], 0.55 [95% CI, 0.54-0.56]), compared with increased likelihood of ER naltrexone (RR, 1.12 [95% CI, 1.05-1.20]) and oral naltrexone (RR, 1.95 [95% CI, 1.86-2.03]) treatment initiation. In model 2 assessing individual cooccurring SUDs, there was decreased likelihood of buprenorphine initiation with cooccurring alcohol use disorder (RR, 0.60 [95% CI, 0.59-0.61]), stimulant use disorder (RR, 0.66 [95% CI, 0.65-0.68]), and sedative use disorder (RR, 0.73 [95% CI, 0.72-0.75]). While cooccurring alcohol use disorder was associated with increased initiation of ER naltrexone (RR, 1.22, [95% CI, 1.13-1.31]) or oral naltrexone (RR, 2.11 [95% CI, 2.02-2.20]), we did not observe an association between stimulant or sedative use disorders and naltrexone initiation, apart from a decrease in ER naltrexone prescriptions in individuals with cooccurring sedative use disorder (RR, 0.90 [95% CI, 0.82-0.99]).
