ArticleThe American journal of psychiatry2023
Risk of Experiencing an Overdose Event for Patients Undergoing Treatment With Medication for Opioid Use Disorder.
Article in The American journal of psychiatry, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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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.
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Who cites it
9 citing papers in PubMed.
- Thresholds for adjunctive medication usage and probability of initiating injectable naltrexone.Addiction (Abingdon, England) · 2026Trial
- Personally-tailored opioid-overdose and medication for opioid use disorder (MOUD) education (TOME) significantly increases MOUD and overdose knowledge in peripartum individuals: Results from a randomized controlled pilot trial.Drug and alcohol dependence · 2025Trial
- Modeling opioid overdose events recurrence with a covariate-adjusted triggering point process.PLoS computational biology · 2025Article
- Article
- Buprenorphine treatment and clinical outcomes under the opioid use disorder cascade of care.Drug and alcohol dependence · 2024Article
- Addressing cortex dysregulation in youth through brain health check coaching and prophylactic brain development.INNOSC theranostics & pharmacological sciences · 2024Article
- High suicidality predicts overdose events among people with substance use disorder: A latent class analysis.Frontiers in public health · 2023Article
- μ-opioid receptor agonists and psychedelics: pharmacological opportunities and challenges.Frontiers in pharmacology · 2023Review
- Scoping review of associations between cytochrome P450 3A4/5 single nucleotide polymorphisms and risk factors for fentanyl overdose.PharmacogenomicsArticle
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Authors and funding
9 authors.
Funding
Abstract
objectiveOverdose risk during a course of treatment with medication for opioid use disorder (MOUD) has not been clearly delineated. The authors sought to address this gap by leveraging a new data set from three large pragmatic clinical trials of MOUD.
methodsAdverse event logs, including overdose events, from the three trials (N=2,199) were harmonized, and the overall risk of having an overdose event in the 24 weeks after randomization was compared for each study arm (one methadone, one naltrexone, and three buprenorphine groups), using survival analysis with time-dependent Cox proportional hazard models.
resultsBy week 24, 39 participants had ≥1 overdose event. The observed frequency of having an overdose event was 15 (5.30%) among 283 patients assigned to naltrexone, eight (1.51%) among 529 patients assigned to methadone, and 16 (1.15%) among 1,387 patients assigned to buprenorphine. Notably, 27.9% of patients assigned to extended-release naltrexone never initiated the medication, and their overdose rate was 8.9% (7/79), compared with 3.9% (8/204) among those who initiated naltrexone. Controlling for sociodemographic and time-varying medication adherence variables and baseline substance use, a proportional hazard model did not show a significant effect of naltrexone assignment. Significantly higher probabilities of experiencing an overdose event were observed among patients with baseline benzodiazepine use (hazard ratio=3.36, 95% CI=1.76, 6.42) and those who either were never inducted on their assigned study medication (hazard ratio=6.64, 95% CI=2.12, 19.54) or stopped their medication after initial induction (hazard ratio=4.04, 95% CI=1.54, 10.65).
conclusionsAmong patients with opioid use disorder seeking medication treatment, the risk of overdose events over the next 24 weeks is elevated among those who fail to initiate or discontinue medication and those who report benzodiazepine use at baseline.
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