Stimulant Use During MOUD Flags Heroin and Injection Risk
This real-world analysis quantifies how stimulant use before and during medication for opioid use disorder predicts heroin use and injection drug use, reinforcing the case for routine stimulant screening in addiction care.
📅 Journal publication: Jul 2026·Last updated: Oct 7, 2026
stimulant usemethamphetaminecocaineopioid use disorderbuprenorphinemethadoneMOUDheroininjection drug usecontingency managementharm reductionobservational cohortaddiction medicineBehavioral Health / Addiction Medicine
Background Information
Stimulant use heightens risk in opioid disorder treatment.
This study highlights the significant impact of stimulant use on high-risk behaviors in patients treated for opioid use disorder. Stimulant use predicted heroin use during treatment and both before and during treatment predicted intravenous drug use. This real-world study underlines the importance of addressing stimulant use in patients undergoing treatment for opioid use disorder to reduce high-risk behaviors. Concurrent stimulant use in opioid disorder treatment raises risk of intravenous use and heroin relapse.
📊 Deep Analysis Available
Subscribers get the full breakdown: study design, outcomes, pharmacist implications, clinical pearls, GRADE evidence grade, and a downloadable PDF report.
Authors:Marino EN, Bone C, Perez MC, Robles RC, Potter JS
Citation:Marino EN, Bone C, Perez MC, et al. Stimulant use predicts high-risk substance use behaviors during medication treatment for opioid use disorder. Addictive behaviors. 2026;178:108673. doi:10.1016/j.addbeh.2026.108673
Subscribers receive access to a complete clinical analysis, available online and as a downloadable PDF.
Executive Summary
Study Design
Patient Population
Primary Outcomes
Secondary Outcomes & Safety Profile
Pharmacist Implications
Clinical Pearls
Limitations
Controversies & Evidence Gaps
Cost & Logistics
Want the full analysis?
Subscribe to PharmD Signal for unrestricted access to every deep analysis, plus PDF reports, GRADE evidence grades, and pharmacist implications for every article we publish.