ArticleAddiction (Abingdon, England)2022
Duration of use and outcomes among people with opioid use disorder initiating methadone and buprenorphine in Ontario: a population-based propensity-score matched cohort study.
Article in Addiction (Abingdon, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed, 35 citations in OpenAlex.
- Methadone vs Buprenorphine-Naloxone in Opioid Overdose Survivors.JAMA network open · 2026Article
- "Safer supply is the thing that changes everything": the role of prescribed safer supply in rebuilding trust following experiences of medical abandonment.BMC public health · 2026Article
- Association between early methadone dose titration and treatment discontinuation and opioid toxicity: A retrospective cohort study.PLoS medicine · 2026Article
- "With this you're not chained down to something": contrasting experiences of opioid agonist treatment and safer supply program participation among people receiving prescribed safer supply.Harm reduction journal · 2026Article
- Harm reduction engagement and ongoing opioid use among adults receiving methadone or buprenorphine in Philadelphia.Harm reduction journal · 2026Article
- Impact of opioid agonist therapies on non-fatal and fatal overdose: treatment patterns among individuals with opioid use disorder in Ontario, Canada.Frontiers in public health · 2026Article
- Opioid dispensing prior to opioid toxicity hospitalizations and emergency department visits in Canada, 2018-2022.PloS one · 2026Article
- The Effect of Opioid Agonist Treatment on Injection-Related Sequelae: A Population-Based Observational Study.Drug safety · 2025Observational
- "From an HCV and HIV point of view, it's been remarkable": A qualitative study about using prescribed safer supply to support people who use drugs along the HIV and HCV prevention and treatment cascades in Ontario, Canada.Journal of the International AIDS Society · 2025Article
- Initiation and Dose of Methadone Monotherapy vs Combination Therapy, 2015 to 2023.JAMA network open · 2025Article
- Duration of Methadone and Buprenorphine-Naloxone Treatment.JAMA network open · 2025Article
- Retention in Opioid Agonist Therapy Among First Nations People.JAMA network open · 2025Article
- Opioid medication doses among safer supply clients: Current safer supply doses and previous OAT experience.Drug and alcohol dependence reports · 2025Article
- Understanding the use of telemedicine across different opioid use disorder treatment models: A scoping review.Journal of telemedicine and telecare · 2025Article
- Outpatient Low-Dose Initiation of Buprenorphine for People Using Fentanyl.JAMA network open · 2025Article
- Initiation of opioid agonist treatment following hospital-treated opioid toxicities and the risk of repeat events in Ontario, Canada: a cohort study using inverse probability of treatment weights.BMJ public health · 2025Article
- Initiation and Dosing of Extended-Release Buprenorphine: A Narrative Review of Emerging Approaches for Patients Who Use Fentanyl.Substance abuse and rehabilitation · 2025Review
- COVID-19 immunisation among individuals with opioid use disorder in Ontario: a population-based cohort study.BMJ public health · 2025Article
- Patient and Prescriber characteristics associated with return to daily-dispense methadone: A multilevel cohort study.PLOS mental health · 2025Article
- Medications for opioid use disorder: Predictors of early discontinuation and reduction of overdose risk in US military veterans by medication type.Addiction (Abingdon, England) · 2025Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo characterize comparative risks and benefits of methadone versus buprenorphine/naloxone in a contemporary cohort where the unregulated drug supply is dominated by fentanyl. DESIGN, SETTING AND
participantsPopulation-based propensity-score matched cohort study conducted in Ontario, Canada among people aged 18+ initiating opioid agonist therapy (OAT) for an opioid use disorder between October 2016 and December 2018 (n = 18 880).
interventionInitiation of methadone versus buprenorphine/naloxone. MEASUREMENTS: The primary outcome was opioid overdose (fatal and non-fatal) while on treatment, with secondary outcomes including opioid overdose (first 30 days of treatment), treatment discontinuation, health-care interactions related to treatment of opioid use disorder, receiving a weekly supply of take-home doses and opioid overdose within 30 days of treatment discontinuation. Outcomes were assessed over 1 year.
findingsOverall, 7517 people initiating buprenorphine were matched to an equal number of methadone-treated individuals. Risk of opioid overdose while on treatment [hazard ratio (HR) = 0.50; 95% confidence interval (CI) = 0.37-0.68] or within the first 30 days of treatment (HR = 0.51, 95% CI = 0.31-0.85) was lower among buprenorphine recipients compared to methadone recipients. In secondary analyses, people initiating buprenorphine had a higher risk of treatment discontinuation within the first year (median time to discontinuation 104 versus 265 days, HR = 1.43, 95% CI = 1.37-1.49), had lower rates of health-care interactions for OUD (186.4 versus 254.3 per person-year; rate ratio = 0.73; 95% CI = 0.72-0.75), and a higher rate of receiving weekly take-home doses (HR = 2.33; 95% CI = 2.20-2.46). Overdose rates in the period following OAT discontinuation were higher than those observed while on treatment, but did not differ significantly by OAT type.
conclusionsAlthough treatment retention is higher among methadone recipients, overdose risk is also elevated compared to buprenorphine recipients. These findings demonstrate the benefits of any OAT on avoidance of overdose, particularly following treatment discontinuation and with the increasingly unpredictable drug supply in North America.
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