ArticleAddiction (Abingdon, England)2020
Opioid agonist treatment and fatal overdose risk in a state-wide US population receiving opioid use disorder services.
Article in Addiction (Abingdon, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07148206 (Dronabinol and Epidiolex to Manage Uncontrolled Residual Symptoms of Buprenorphine Initiation Trial), which is not on this map. Cited by 117 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.
Dronabinol and Epidiolex to Manage Uncontrolled Residual Symptoms of Buprenorphine Initiation Trial
Who cites it
117 citing papers in PubMed, 2 syntheses or guidelines pooled it, 165 citations in OpenAlex.
- CDC Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2022Guideline
- The impact of methamphetamine/amphetamine use on receipt and outcomes of medications for opioid use disorder: a systematic review.Addiction science & clinical practice · 2021Pooled it
- Impact of COVID-19-related methadone regulatory flexibilities: views of state opioid treatment authorities and program staff.Addiction science & clinical practice · 2023Trial
- Continuity of Medications for Opioid Use Disorder in States With and Without Medicaid Prescription Cap Policies.Medical care · 2026Article
- Adults with problematic opioid use released from jail: Mutual help groups and medication support contribute to a greater likelihood of opioid abstinence.Drug and alcohol dependence · 2026Article
- Pharmacological Management of Opioid Use Disorder: A Systematic Review and Network Meta-Analysis: Prise en charge pharmacologique du trouble de l'usage des opiacés : revue systématique et méta-analyse en réseau.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2026Review
- Buprenorphine Dispensed by Pharmacies and Administered in Emergency Departments in Urban and Rural Areas - United States, 2019-2025.MMWR. Morbidity and mortality weekly report · 2026Article
- Concurrent Use of Extra-Medical Medication for Opioid Use Disorder Among Adults Prescribed Methadone or Buprenorphine: A Cohort Study of Urban Adults Who Have Injected Drugs.Drug and alcohol review · 2026Article
- "How are we going to be able to pull that off?": staff perspectives on the early implementation of mobile medication units in New York State.Addiction science & clinical practice · 2026Article
- County-Level Variation in Substance Use Disorder Service Utilization by Insurance Payers and Self-Pay in the United States.The Journal of clinical psychiatry · 2026Article
- "This whole thing is relationship medicine": A qualitative analysis of mobile and street-delivered medication for opioid use disorder in King County, Washington, using RE-AIM.Research square · 2026Article
- Association between early methadone dose titration and treatment discontinuation and opioid toxicity: A retrospective cohort study.PLoS medicine · 2026Article
- Treatment gaps for opioid use disorder among commercially insured US surgical patients, 2016-2022.Regional anesthesia and pain medicine · 2026Article
- Article
- Pre-exposure prophylaxis (PrEP) and medications for opioid use disorder for persons who inject drugs: the CHORUS + randomized controlled trial study protocol.Addiction science & clinical practice · 2025Article
- Understanding overdose risk and response in permanent supportive housing: results of focus groups with tenants, staff, and leaders.Addiction science & clinical practice · 2025Article
- Investigating heterogeneous effects of an expanded methadone access policy with opioid treatment program retention: a Rhode Island population-based retrospective cohort study.American journal of epidemiology · 2025Article
- Medicaid health home design and buprenorphine receipt, 2009-2020.Journal of substance use and addiction treatment · 2025Article
- A mixed-method exploratory assessment of provider-based stigma of opioid use disorder (OUD) and support for medications for opioid use disorder (MOUD) in carceral settings.Harm reduction journal · 2025Article
- Tailored Therapies in Addiction Medicine: Redefining Opioid Use Disorder Treatment with Precision Medicine.Journal of personalized medicine · 2025Review
57 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
BACKGROUND AND
aimsEvidence from randomized controlled trials establishes that medication treatment with methadone and buprenorphine reduces opioid use and improves treatment retention. However, little is known about the role of such medications compared with non-medication treatments in mitigating overdose risk among US patient populations receiving treatment in usual care settings. This study compared overdose mortality among those in medication versus non-medication treatments in specialty care settings.
designRetrospective cohort study using state-wide treatment data linked to death records. Survival analysis was used to analyze data in a time-to-event framework.
settingServices delivered by 757 providers in publicly funded out-patient specialty treatment programs in Maryland, USA between 1 January 2015 and 31 December 2016.
participantsA total of 48 274 adults admitted to out-patient specialty treatment programs in 2015-16 for primary diagnosis of opioid use disorder. MEASUREMENTS: Main exposure was time in medication treatment (methadone/buprenorphine), time following medication treatment, time exposed to non-medication treatments and time following non-medication treatment. Main outcome was opioid overdose death during and after treatment. Hazard ratios were calculated using Cox proportional hazard regression. Propensity score weights were adjusted for patient information on sex, age, race, region of residence, marital and veteran status, employment, homelessness, primary opioid, mental health treatment, arrests and criminal justice referral.
findingsThe study population experienced 371 opioid overdose deaths. Periods in medication treatment were associated with substantially reduced hazard of opioid overdose death compared with periods in non-medication treatment [adjusted hazard ratio (aHR) = 0.18, 95% confidence interval (CI) = 0.08-0.40]. Periods after discharge from non-medication treatment (aHR = 5.45, 95% CI = 2.80-9.53) and medication treatment (aHR = 5.85, 95% CI = 3.10-11.02) had similar and substantially elevated risks compared with periods in non-medication treatments.
conclusionsAmong Maryland patients in specialty opioid treatment, periods in treatment are protective against overdose compared with periods out of care. Methadone and buprenorphine are associated with significantly lower overdose death compared with non-medication treatments during care but not after treatment is discontinued.
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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.