Trial reportAddiction (Abingdon, England)2022
Impact of fentanyl use on initiation and discontinuation of methadone and buprenorphine/naloxone among people with prescription-type opioid use disorder: secondary analysis of a Canadian treatment trial.
Trial report 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 22 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
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Addressing tobacco use in the context of opioid use disorder: A systematic review of smoking cessation interventions.The American journal on addictions · 2026Pooled it
- Opioid agonist therapy for opioid use disorder in primary versus specialty care.The Cochrane database of systematic reviews · 2025Pooled it
- Comparison of Extended-Release Buprenorphine Doses for Treating High-Risk Opioid Use: A Randomized Clinical Trial.JAMA network open · 2025Trial
- Trial
- Randomized, placebo-controlled trial of gabapentin during outpatient buprenorphine-assisted taper and transition to injectable naltrexone.The American journal of drug and alcohol abuse · 2025Trial
- Mesolimbic and mesocortical pathways differentially support fentanyl-context associations.Psychopharmacology · 2026Article
- Harm reduction engagement and ongoing opioid use among adults receiving methadone or buprenorphine in Philadelphia.Harm reduction journal · 2026Article
- Projection-defined ventral tegmental area neurons exhibit fentanyl-induced molecular and functional adaptations that differentially support drug-context associations.bioRxiv : the preprint server for biology · 2025Article
- A Drd1-cre mouse line with nucleus accumbens gene dysregulation exhibits blunted fentanyl seeking.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2025Article
- Multilevel determinants of medication preferences for opioid use disorder among criminal-legal-involved populations: Insights from a scoping review.Drug and alcohol dependence reports · 2025Review
- Effectiveness of Washington State's hub and spoke model to improve opioid use disorder outcomes.Health affairs scholar · 2025Article
- Health and Economic Impact of Periodic Hepatitis C Virus Testing Among People Who Inject Drugs.JAMA health forum · 2025Article
- A cross-sectional study of differences in medication for opioid use disorder receipt among pregnant people enrolled in Medicaid in Oregon, United States.Addiction (Abingdon, England) · 2025Article
- Initiation and Dosing of Extended-Release Buprenorphine: A Narrative Review of Emerging Approaches for Patients Who Use Fentanyl.Substance abuse and rehabilitation · 2025Review
- Pharmacological Strategies to Decrease Long-Term Prescription Opioid Use: A Systematic Review.Journal of clinical medicine · 2024Review
- The Association Between Self-Reported Anxiety and Retention in Opioid Agonist Therapy: Findings From a Canadian Pragmatic Trial.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2024Article
- Article
- Reconsidering the usefulness of long-term high-dose buprenorphine.Frontiers in psychiatry · 2024Article
- Managing Opioid Withdrawal Symptoms During the Fentanyl Crisis: A Review.Substance abuse and rehabilitation · 2024Review
- Antecedents of fatal overdose in an adult cohort identified through administrative record linkage in Indiana, 2015-2022.Drug and alcohol dependence · 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
13 authors at 7 institutions in 3 countries.
Funding
Abstract
BACKGROUND AND
aimsFentanyl is primarily responsible for the current phase of the overdose epidemic in North America. Despite the benefits of treatment with medications for opioid use disorder (MOUD), there are limited data on the association between fentanyl, MOUD type and treatment engagement. The objectives of this analysis were to measure the impact of baseline fentanyl exposure on initiation and discontinuation of MOUD among individuals with prescription-type opioid use disorder (POUD). DESIGN, SETTING AND
participantsSecondary analysis of a Canadian multi-site randomized pragmatic trial conducted between 2017 and 2020. Of the 269 randomized participants, 65.4% were male, 67.3% self-identified as white and 55.4% had a positive fentanyl urine drug test (UDT) at baseline. Fentanyl-exposed participants were more likely to be younger, to self-identify as non-white, to be unemployed or homeless and to be currently using stimulants than non-fentanyl-exposed participants.
interventionsFlexible take-home dosing buprenorphine/naloxone or supervised methadone models of care for 24 weeks. MEASUREMENTS: Outcomes were (1) MOUD initiation and (2) time to (a) assigned and (b) overall MOUD discontinuation. Independent variables were baseline fentanyl UDT (predictor) and assigned MOUD (effect modifier).
findingsOverall, 209 participants (77.7%) initiated MOUD. In unadjusted analyses, fentanyl exposure was associated with reduced likelihood of treatment initiation [odds ratio (OR) = 0.18, 95% confidence interval (CI) = 0.08-0.36] and shorter median times in assigned [20 versus 168 days, hazard ratio (HR) = 3.61, 95% CI = 2.52-5.17] and any MOUD (27 versus 168 days, HR = 3.32, 95% CI = 2.30-4.80). The negative effects were no longer statistically significant in adjusted models, and no interaction between fentanyl and MOUD was observed for any of the outcomes (all P > 0.05).
conclusionsBoth buprenorphine/naloxone and methadone may be appropriate treatment options for people with prescription-type opioid use disorder regardless of fentanyl exposure. Other characteristics of fentanyl-exposed individuals appear to be driving the association with poorer treatment outcomes.
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What OpenQuestion holds
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.