Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

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.


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.

This Week's Must Reads

Intensive BP Control & Risk of Dementia, JAMA; ePub 2019 Jan 28; SPRINT MIND Investigators

Outpatient Care for Adults With Primary Care, JAMA Intern Med; ePub 2019 Jan 28; Levine, et al

Antibiotic Therapy in Patients with Asthma, JAMA Intern Med; ePub 2019 Jan 28; Stefan, et al

Outpatient Benzodiazepine Prescribing in US, JAMA Netw Open; 2019 Jan 25; Agarwal, et al

Reduction of Readmissions Through Primary Care, JAMA Netw Open; 2019 Jan 25; Wiest, et al

Must Reads in Pain

Trends in Pain Prevalence in US Adults, J Pain; ePub 2019 Jan 15; Nahin, et al

Prescribed Opioids & Risk of CAP in Patients with HIV, JAMA Intern Med; 2019 Jan 7; Edelman, et al

Opioid-Involved Overdose Deaths in the US, MMWR; 2019 Jan 4; Scholl, Seth, et al

Dental Opioid Prescriptions & Subsequent Abuse, JAMA Intern Med; ePub 2018 Dec 3; Schroeder, et al

Risk of Opioid Overdose Hospitalizations , J Am Board Fam Med; 2018 Nov-Dec; Peters, et al