Subtypes of patients with opioid use disorder in methadone maintenance treatment: A pathways model analysis

This study applied constructs from a widely-utilized subtyping model in the field of gambling studies, the Pathways Model, to a sample of 118 patients with opioid use disorder receiving methadone-maintenance-treatment. Surveys were analyzed using latent class analysis (LCA) to examine whether the Pathways Model indicators distinguished class membership, with confidence band interpretation used to compare class scores, and multinomial logistic regression conducted to examine associations with other correlates. LCA fit indices supported a three-class solution: (1) ‘opioid-related only’ (55.9%), (2) ‘personal trauma/emotionally vulnerable’ (15.3%), and (3) ‘impulsive/current psychopathology’ (28.8%). Class 1 was characterized by lower scores on nearly all indicators. Class 2 was characterized by the highest scores for personal experiences with sexual, physical, and emotional abuse during childhood and interpersonal trauma, and high impulsivity scores. Class 3 was characterized by the highest scores on stress, depression, loneliness, and impulsivity. Classes 2 and 3 both had higher scores for witnessing community violence, opioid-related coping motives, and impulsivity than Class 1. Gender, age, opioid-related consequences, and social network substance misuse were associated with membership. Our findings generally demonstrate trans-diagnostic overlap with the Pathways Model, offering support for the model’s translation to other addictions.