Clinical Edge

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Medication Use for Opioid Use Disorder

Ann Intern Med; ePub 2018 Jun 19; Larochelle, et al

Only a minority of opioid overdose survivors received medications for opioid use disorder (MOUD) after nonfatal overdose, with buprenorphine and methadone maintenance treatment (MMT) associated with reduced all-cause and opioid-related mortality. This according to a recent retrospective cohort study that included 17,568 adults from Massachusetts without cancer who survived an opioid overdose between 2012 and 2014. 3 types of MOUD were examined: MMT, buprenorphine, and naltrexone. Exposure to MOUD was identified at monthly intervals, and persons were considered exposed through the month after last receipt. Researchers found:

  • In the 12 months after a nonfatal overdose, 2,040 persons (11%) enrolled in MMT for a median of 5 months, 3,022 persons (17%) received buprenorphine for a median of 4 months, and 1,099 persons (6%) received naltrexone for a median of 1 month.
  • All-cause mortality was 4.7 deaths per 100 person-years among the entire cohort, and opioid-related mortality was 2.1 deaths per 100 person-years.
  • Buprenorphine and MMT were associated with reduced all-cause and opioid-related mortality.
  • There were no associations between naltrexone and all-cause mortality or opioid-related mortality.

Citation:

Larochelle MR, Bernson D, Land T, et al. Medication for opioid use disorder after nonfatal opioid overdose and association with mortality: A cohort study. [Published online ahead of print June 19, 2018]. Ann Intern Med. doi:10.7326/M17-3107.

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