SynthesisPloS one2022
Relative effectiveness of medications for opioid-related disorders: A systematic review and network meta-analysis of randomized controlled trials.
Synthesis in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 5 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
24 citing papers in PubMed, 5 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Effectiveness and safety of therapies for patients with opioid use disorder: a systematic review and network meta-analysis.Journal of comparative effectiveness research · 2026Pooled it
- Oral and injectable opioid agonist treatments for people who use street opioids: a systematic literature review and network meta-analysis.BMC public health · 2025Pooled it
- Guideline
- Management of opioid use disorder: 2024 update to the national clinical practice guideline.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Guideline
- The effects of naltrexone on retention in treatment and being opioid-free in opioid-dependent people: A systematic review and meta-analysis.Frontiers in psychiatry · 2022Pooled it
- Psilocybin in the Treatment of Cocaine Use Disorder: A Randomized Clinical Trial.JAMA network open · 2026Trial
- 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
- Assessing usability and acceptability of a VR digital therapeutic for treatment of substance use disorders.Journal of social work practice in the addictions · 2026Article
- Effectiveness of slow-release oral morphine versus other OAT regimens in key sub-populations: protocol for population-based target trial emulation.medRxiv : the preprint server for health sciences · 2025Article
- The Effect of Opioid Agonist Treatment on Injection-Related Sequelae: A Population-Based Observational Study.Drug safety · 2025Observational
- State Laws Banning Prior Authorization For Medications For Opioid Use Disorder Increased Substantially, 2015-23.Health affairs (Project Hope) · 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
- 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
- Article
- Adolescent Treatment Landscape of Depression, Suicidality, and Substance Use Disorder in the US.JAMA health forum · 2025Article
- Article
- The role of attachment and personality traits in choosing opiate addiction replacement therapy.Scientific reports · 2024Article
- Willingness to utilize a mobile treatment unit in five counties at the epicenter of the US rural opioid epidemic.Journal of substance use and addiction treatment · 2024Article
- Loss, liberation, and agency: Patient experiences of methadone treatment at opioid treatment programs during the COVID-19 pandemic.Journal of substance use and addiction treatment · 2024Article
- No obvious effect on mortality from a patient choice reform expanding access to opioid disorder treatment - results from a natural experiment of policy change in Sweden.Substance abuse treatment, prevention, and policy · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSeveral pharmacotherapeutic interventions are available for maintenance treatment for opioid-related disorders. However, previous meta-analyses have been limited to pairwise comparisons of these interventions, and their efficacy relative to all others remains unclear. Our objective was to unify findings from different healthcare practices and generate evidence to strengthen clinical treatment protocols for the most widely prescribed medications for opioid-use disorders.
methodsWe searched Medline, EMBASE, PsycINFO, CENTRAL, and ClinicalTrials.gov for all relevant randomized controlled trials (RCT) from database inception to February 12, 2022. Primary outcome was treatment retention, and secondary outcome was opioid use measured by urinalysis. We calculated risk ratios (RR) and 95% credible interval (CrI) using Bayesian network meta-analysis (NMA) for available evidence. We assessed the credibility of the NMA using the Confidence in Network Meta-Analysis tool.
resultsSeventy-nine RCTs met the inclusion criteria. Due to heterogeneity in measuring opioid use and reporting format between studies, we conducted NMA only for treatment retention. Methadone was the highest ranked intervention (Surface Under the Cumulative Ranking [SUCRA] = 0.901) in the network with control being the lowest (SUCRA = 0.000). Methadone was superior to buprenorphine for treatment retention (RR = 1.22; 95% CrI = 1.06-1.40) and buprenorphine superior to naltrexone (RR = 1.39; 95% CrI = 1.10-1.80). However, due to a limited number of high-quality trials, confidence in the network estimates of other treatment pairs involving naltrexone and slow-release oral morphine (SROM) remains low.
conclusionAll treatments had higher retention than the non-pharmacotherapeutic control group. However, additional high-quality RCTs are needed to estimate more accurately the extent of efficacy of naltrexone and SROM relative to other medications. For pharmacotherapies with established efficacy profiles, assessment of their long-term comparative effectiveness may be warranted.
trial registrationThis systematic review has been registered with PROSPERO (https://www.crd.york.ac.uk/prospero) (identifier CRD42021256212).
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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.