Rates of stimulant use and treatment initiation or engagement
TEDS
All individuals in the CTN studies had access to and were expected to initiate buprenorphine or XR-NTX as part of their study participation. A total of 80% of participants initiated MOUD during the trials (543/673). Rates were higher in X:BOT (83%) than CHOICES (68%), explained by their inpatient vs. outpatient treatment initiation settings. Initiation on buprenorphine was more likely than XR-NTX (90% vs. 71%). Similarly, all included TEDS treatment episodes had MOUD as part of the treatment plan, but TEDS does not report whether or not MOUD treatment was actually initiated. The NSDUH does not ask about MOUD treatment specifically, but 58% of included NSDUH respondents accessed some form of SUD treatment in the past year (but were still actively using opioids at the time of survey response). Among those who had not, 45% reported trying but being unable to access treatment and 55% had not tried. Among ROI participants, 38% reported engagement in inpatient or outpatient SUD treatment in the past 6 months and 64% of those without recent treatment engagement indicated that they had tried but were unable to obtain treatment.At baseline, 105/673 (16%) CTN trial participants tested UDS positive for stimulants (26 MA/amphetamines only, 75 cocaine only, and four used both). Monthly stimulant use rates at follow-up ranged from 15 to 30% (mean 25%, standard deviation 5%).