Polysubstance Use among Patients of Opioid Use Disorder on Buprenorphine Opioid Substitution Therapy Based on Urine Drug Test Analysis

Background: Opioid use disorder (OUD) patients often use other substances. Polysubstance use is a concern for patients treated for OUD. While buprenorphine opioid substitution therapy (OST) curtails harmful opioid use, co-occurring use of substances, such as cannabis and cocaine may negatively affect treatment outcomes. Aims: (1) To assess the extent of comorbid substance use in patients of OUD on OST by self-reporting and urine drug test analysis. (2) To study the correlation of comorbid substance use with disease and treatment variables in patients of OUD on OST. Methodology: Urine drug test (UDT) results were taken from routine screening of OST patients in the month of February 2022 who gave consent. Pre- and post-interview were taken. Data collection was done using the records of patients. Incomplete records were excluded from the study. The records were then reviewed for various details. Results: Out of the 29 study participants, self-reporting for recent use of opioids by none, 62.08%, 3.44%, 6.89%, and 96.55% reported using cannabis, sedative-hypnotics, alcohol, and tobacco, respectively. In contrast, 10.34% tested positive for street opioids in UDT, 72.41% for cannabis, and 10.34% for sedative-hypnotics. Significant associations were found between education, occupation, and monthly income, with the treatment adherence on OST; also noted between monthly income and UDT positivity of morphine. Conclusion: Tobacco and cannabis are the most common comorbid substances found in OUD patients on OST. Those having consumed cannabis recently are more likely to consume street opioids as well. They are more likely to give an accurate history of cannabis as compared to street opioids and benzodiazepines.