Buprenorphine-Naloxone vs Extended-Release Naltrexone Following Opioid Withdrawal Treatment

What is the comparative effectiveness of buprenorphine-naloxone vs extended-release (XR) naltrexone for all-cause mortality and nonfatal opioid overdose among adults after discharge from medically managed opioid withdrawal treatment?In this comparative effectiveness study using a target trial emulation framework of 106 052 discharge episodes from opioid withdrawal treatment followed up for 24 weeks, the cumulative incidence of nonfatal overdose was lower for buprenorphine-naloxone than for XR naltrexone, but risk of all-cause mortality was similar between the 2 treatment groups.Findings from this study using observational data provide further evidence of improved outcomes for individuals treated with buprenorphine-naloxone compared with XR naltrexone.

Corresponding Author: Heather E. Hsu, MD, MPH, Division of Pediatric Health Services Research, 801 Albany St, Floor 2N, Boston, MA 02119 (heather.hsu@bmc.org).

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