Conclusion
polysubstance, OUD
This study emphasizes the negative impact that stimulant use may have on MOUD initiation in trials and extrapolates findings to three real-world populations needing OUD treatment, where polysubstance use is the norm rather than the exception. Although broadening the availability of MOUD is expected to improve the public health burden of opioid use, rapidly increasing rates of concomitant stimulant use may reduce its impact. An analysis of urine drug screens from 150,000 buprenorphine patients showed 10% cocaine and 30% MA positivity rates [