ArticleGeneral hospital psychiatry
Risk of self-harm and overdose after starting buprenorphine for opioid use disorder.
Article in General hospital psychiatry. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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Who cites it
1 citing paper in PubMed.
- Methodological innovations to advance substance use disorder research: Proceedings of a NIDA workshop on target trial emulation and translational testing of digital health tools.Journal of substance use and addiction treatment · 2026Article
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Authors and funding
9 authors.
Funding
Abstract
objectiveCompare risk of intentional self-harm and overdose after visits for opioid use disorder (OUD) followed by starting vs. not starting buprenorphine.
methodsRecords from four health systems identified visits during 1/1/2012-12/31/2019 by health system members aged 13 or older with OUD diagnosis and no recent OUD medication. Following a target-trial emulation approach, visits followed by buprenorphine dispensing within 7 days were matched to unexposed visits. Analyses compared risk of diagnosed self-harm injury or poisoning (primary outcome) as well as opioid-involved poisoning and any injury or poisoning (secondary outcomes) within 90 days.
resultsAmong 183,809 visits by 30,955 patients, 15,508 (8.4 %) had buprenorphine dispensing within 7 days, and 2260 (1.2 %) had self-harm diagnosis within 90 days. Average duration of buprenorphine treatment before interruption was 44.3 days (SD 32.1). In primary intention-to-treat analyses using logistic regression and adjusting for baseline risk of self-harm, starting buprenorphine was not associated with significant difference in self-harm (odds ratio [OR] 1.01, 95 % CI 0.81-1.24) or opioid-involved poisoning (OR 1.09, 95 % CI 0.86-1.38). In secondary as-treated analyses censoring outcomes after treatment change, buprenorphine initiation was associated with no significant difference in hazard of self-harm (Hazard Ratio [HR] 0.74, 95 % CI 0.53-1.02) and with significantly lower hazard of opioid-involved poisoning (HR 0.63, 95 % CI 0.43-0.94).
conclusionsAmong people with OUD, starting buprenorphine was not followed by lower risk of self-harm, likely reflecting frequent discontinuation and high risk of self-harm or overdose shortly after discontinuation. These findings reinforce the need to improve treatment continuity among those starting buprenorphine.
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