ArticleDrug and alcohol dependence2024
Buprenorphine treatment and clinical outcomes under the opioid use disorder cascade of care.
Article in Drug and alcohol dependence, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Can Buprenorphine Be Overdosed? The Ceiling Effect and Its Clinical Implications.Pharmaceuticals (Basel, Switzerland) · 2026Review
- The HEALing Measurement Center: a stepped wedge cluster randomized study protocol to enhance opioid use disorder recovery through measurement based care.Implementation science : IS · 2026Article
- Timely Receipt of New Medication Treatment After Acute Care Encounters for Opioid Overdose in the U.S. Medicaid Population.Journal of general internal medicine · 2026Article
- Variation in the quality of opioid use disorder treatment in the Medicaid population in 2019.PloS one · 2026Article
- The psychosocial pain management to improve opioid use disorder treatment outcomes study: Protocol for a randomized controlled trial.Contemporary clinical trials · 2025Article
- Effectiveness of Washington State's hub and spoke model to improve opioid use disorder outcomes.Health affairs scholar · 2025Article
- mHealth Incentivized Adherence Plus Patient Navigation (MIAPP): protocol for a pilot randomized controlled trial to improve linkage and retention on buprenorphine for hospitalized patients with methamphetamine use and opioid use disorder.Addiction science & clinical practice · 2025Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundChallenges to engagement and retention on buprenorphine undermine treatment of individuals with opioid use disorder (OUD). Under the OUD Cascade of Care framework, we sought to identify patient characteristics and treatment response associated with superior clinical outcomes.
methodsA retrospective cohort study of specialty buprenorphine treatment patients entering treatment (n=19,487) based on EHR records from a large multi-state buprenorphine treatment network (2011-2019). Person-level care episodes were evaluated across treatment intake, engagement (i.e. 2+ visits in the month following intake), and retention at 6, 12, and 24 months. Time to achieving 90 days of continuous opioid abstinence was assessed using Cox proportional hazards regressions models and also assessed as a predictor of long-term retention.
resultsMost patients engaged (82.4 %), but retention steadily declined over 6-month (38.7 %), 12-month (26.2 %), and 24-month (17.1 %) timepoints. Opioid-positive baseline tests were associated with lower hazards of achieving continuous abstinence for both buprenorphine-positive (aHR=0.33, p<.001) and buprenorphine-negative (aHR=0.49,p<.001) intakes. Opioid abstinence was associated with buprenorphine-positive baseline testing (aHR=1.59,p<.001), especially for those testing opioid-negative (aHR=1.82,p<.001). Patients who achieved and sustained abstinence at 6 months in care were 4.1 and 5.5 times as likely to achieve 12-month and 24-month retention, respectively, compared to patients with intermittent opioid use.
conclusionTreatment discontinuation was concentrated early in care and buprenorphine and opioid status at intake were prognostic of achieving and sustaining abstinence. Early abstinence was associated with higher likelihood of subsequent stage progression. Implementing interventions to support early clinical stability for high-risk patients is critical to improve clinical outcomes.
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