Original Investigation

Methadone Dose and Patient-Directed Discharge in Hospitalized Patients With Opioid Use Disorder

JAMA Network Open 10.1001/jamanetworkopen.2026.3439

March 25, 2026 at 11:00 AM EDT

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Among hospitalized patients with opioid use disorder, is there an association between the early cumulative dose of methadone and risk of patient-directed discharge?In this cohort study of 554 adults with opioid use disorder who were admitted to the hospital and received methadone during the first 72 hours, there was a decreased risk of patient-directed discharge with increased methadone dose given during the first 24 hours of care in an adjusted analysis.These findings suggest that in the fentanyl era, early treatment with a higher cumulative dose of methadone may be associated with reduced patient-directed discharge.

Corresponding Author: William M. Garneau, MD, Division of Hospital Medicine, Department of Medicine, Johns Hopkins Hospital, 600 N Wolfe St, Carnegie 2nd Floor, Suite 249, Baltimore, MD 21287 (william.garneau@jhmi.edu).

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