# Who are we reaching? Identifying subgroups among individuals seeking help for opioid use disorder

## TL;DR

This study identifies three distinct groups among people seeking help for opioid addiction, each with unique needs and characteristics, to improve targeted care strategies.

## Contribution

The study introduces a novel classification of opioid use disorder help-seekers using latent class analysis to inform tailored care approaches.

## Key findings

- Three distinct subgroups of opioid use disorder help-seekers were identified based on substance use and vulnerability profiles.
- Each subgroup exhibits unique sociodemographic and clinical characteristics that suggest different care requirements.
- Integrated health and social services are recommended for individuals who inject drugs to address their complex needs.

## Abstract

Opioid use disorder (OUD) represents a major challenge in addiction care, yet empirical insights into the sociodemographic, clinical, and care-related profiles of help-seekers remain limited. Understanding these profiles is essential for developing targeted care strategies. This study therefore aims to identify and describe latent classes of help-seekers with OUD and outline their specific needs.

Latent Class Analysis was applied to routinely collected person-level data from the 2023 Berlin Addiction Care Statistical Service to identify latent classes of outpatient help-seekers with OUD. Comorbid substance use disorders (SUDs) and injection drug use served as indicators. Classes were compared across sociodemographic, clinical, and care-related variables using Bonferroni-adjusted χ²-tests.

Among 2,833 help-seekers, three latent classes were identified: Individuals Primarily Using Opioids (n = 1,381), Individuals with Multiple SUDs (n = 709), and Individuals Who Inject Drugs (n = 743). Individuals Primarily Using Opioids did not exhibit clearly distinctive patterns of service utilization and disproportionately reported methadone or other opioids as their main substances of use. Individuals with Multiple SUDs were characterized by high social stability (e.g., partnerships, independent living) and a high enrolment in opioid agonist treatment (OAT). Individuals Who Inject Drugs were marked by heightened vulnerability, including precarious housing and elevated rates of HIV and hepatitis C and primarily accessed low-threshold services.

The results highlight the heterogeneity of help-seekers with OUD and emphasize the need for targeted, class-specific care strategies. Individuals Primarily Using Opioids warrant further investigation, as this class may still comprise heterogeneous subgroups with diverse care needs. Individuals with Multiple SUDs may benefit from more flexible OAT frameworks that accommodate work and family responsibilities. For Individuals Who Inject Drugs, integrated health and social services, combined with expanded harm reduction efforts (e.g., syringe exchange, testing opportunities for infectious diseases), may help reduce access barriers and effectively address their complex needs.