ArticleThe American journal of psychiatry2020
Acute Care, Prescription Opioid Use, and Overdose Following Discontinuation of Long-Term Buprenorphine Treatment for Opioid Use Disorder.
Article in The American journal of psychiatry, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 110 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
110 citing papers in PubMed, 2 syntheses or guidelines pooled it, 203 citations in OpenAlex.
- Follow-up after ED visits for opioid use disorder: Do they reduce future overdoses?Journal of substance abuse treatment · 2022Pooled it
- Adjunct interventions to standard medical management of buprenorphine in outpatient settings: A systematic review of the evidence.Drug and alcohol dependence · 2021Pooled it
- Thresholds for adjunctive medication usage and probability of initiating injectable naltrexone.Addiction (Abingdon, England) · 2026Trial
- Offering nurse care management for opioid use disorder in primary care: Impact on emergency and hospital utilization in a cluster-randomized implementation trial.Drug and alcohol dependence · 2024Trial
- Discontinuation of medication treatment for opioid use disorder after a successful course: The discontinuation phase of the CTN-0100 (RDD) trial.Contemporary clinical trials · 2024Trial
- Design of CLARO+ (Collaboration Leading to Addiction Treatment and Recovery from Other Stresses, Plus): A randomized trial of collaborative care to decrease overdose and suicide risk among patients with co-occurring disorders.Contemporary clinical trials · 2023Trial
- Patient Characteristics Associated with Opioid Abstinence after Participation in a Trial of Buprenorphine versus Injectable Naltrexone.Substance use & misuse · 2022Trial
- Transition of Patients with Opioid Use Disorder from Buprenorphine to Extended-Release Naltrexone: A Randomized Clinical Trial Assessing Two Transition Regimens.The American journal on addictions · 2020Trial
- Continuity of Medications for Opioid Use Disorder in States With and Without Medicaid Prescription Cap Policies.Medical care · 2026Article
- Discontinuing extended-release buprenorphine: Participant experiences from a mixed-methods observational study.Drug and alcohol dependence reports · 2026Article
- Medication and Acute Care Use in Young Adults With Opioid Use Subject to Medicaid Prescription Caps.JAMA health forum · 2026Article
- Health Plan Disenrollment and Mortality After Initiation of Medications for Opioid Use Disorder.JAMA psychiatry · 2026Article
- Evaluating the optimal duration of medication treatment for opioid use disorder.Addiction (Abingdon, England) · 2026Article
- Article
- Identifying risk factors for drug use recurrence with ecological momentary assessment, wearable technologies, and machine learning: a feasibility trial of peer recovery support specialist intervention.Frontiers in digital health · 2026Article
- Subgroup identification of disparities in buprenorphine discontinuation in opioid-use disorder: A Virtual Twins machine learning approach using nationwide United States claims data, 2006-2022.PLOS mental health · 2026Article
- Buprenorphine and Methadone Discontinuation During Pregnancy and the Postpartum Period: A Nationwide Cohort Study.The American journal of psychiatry · 2025Article
- Racial Inequality in Receipt of Medications for Opioid Use Disorder in Nationwide Outpatient Settings-A Cross-sectional Study.Journal of general internal medicine · 2025Observational
- Predictors of Medicaid managed care plan performance on opioid use disorder treatment quality metrics.Drug and alcohol dependence · 2025Article
- System dynamics modeling to inform implementation of evidence-based prevention of opioid overdose and fatality: A state-level model from the New York HEALing Communities Study.The International journal on drug policy · 2025Article
50 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
objectiveAlthough buprenorphine treatment reduces risk of overdose and death in opioid use disorder, most patients discontinue treatment within a few weeks or months. Adverse health outcomes following buprenorphine discontinuation were compared among patients who were successfully retained beyond 6 months of continuous treatment, a minimum treatment duration recently endorsed by the National Quality Forum.
methodsA retrospective longitudinal cohort analysis was performed using the MarketScan multistate Medicaid claims database (2013-2017), covering 12 million beneficiaries annually. The sample included adults (18-64 years of age) who received buprenorphine continuously for ≥180 days by cohorts retained for 6-9 months, 9-12 months, 12-15 months, and 15-18 months. For outcome assessment in the postdiscontinuation period, patients had to be continuously enrolled in Medicaid for 6 months after buprenorphine discontinuation. Primary adverse outcomes included all-cause emergency department visits, all-cause inpatient hospitalizations, opioid prescriptions, and drug overdose (opioid or non-opioid).
resultsAdverse events were common across all cohorts, and almost half of patients (42.1%-49.9%) were seen in the emergency department at least once. Compared with patients retained on buprenorphine for 6-9 months (N=4,126), those retained for 15-18 months (N=931) had significantly lower odds of emergency department visits (odds ratio=0.75, 95% CI=0.65-0.86), inpatient hospitalizations (odds ratio=0.79, 95% CI=0.64-0.99), and filling opioid prescriptions (odds ratio=0.67, 95% CI=0.56-0.80) in the 6 months following discontinuation. Approximately 5% of patients across all cohorts experienced one or more medically treated overdoses.
conclusionsRisk of acute care service use and overdose were high following buprenorphine discontinuation irrespective of treatment duration. Superior outcomes became significant with treatment duration beyond 15 months, although rates of the primary adverse outcomes remained high.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.