Population-Level Health Benefits and Harms Associated With Buprenorphine/Naloxone vs Methadone

What are the combined population-level health outcomes associated with treatment with buprenorphine/naloxone compared with methadone, accounting for differences in treatment retention and risk of mortality?This decision analytical modeling study among 40 461 individuals receiving opioid agonist treatment found population health losses with buprenorphine/naloxone compared with methadone across all model specifications, subgroups, and sensitivity analyses. Any potential advantages from a reduced risk of mortality while individuals were receiving treatment with buprenorphine/naloxone were outweighed by deficits in treatment retention.Findings from this study do not support recommendations of buprenorphine/naloxone as first-line treatment over methadone.

Corresponding Author: Bohdan Nosyk, PhD, Faculty of Health Sciences, Simon Fraser University, BLU 9706, 8888 University Dr, Burnaby, BC, Canada V5A 1S6 (bnosyk@sfu.ca).

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