Patients treated with methadone for opioid use disorder had a lower rate of treatment discontinuation compared to those receiving buprenorphine/naloxone over 24 months, according to a recent study.

The population-based cohort study conducted in British Columbia assessed the comparative effectiveness of buprenorphine/naloxone vs. methadone for opioid use disorder treatment. The study included 30,891 patients, analyzing treatment discontinuation and mortality outcomes over a 24-month period. The results demonstrated a higher rate of treatment discontinuation for patients receiving buprenorphine/naloxone compared with methadone (88.8% vs 81.5%, respectively), with an adjusted hazard ratio (HR) of 1.58. In a per-protocol analysis, the discontinuation rates remained higher for buprenorphine/naloxone (42.1%) vs methadone (30.7%).

Mortality rates during treatment were low for both groups, with 0.08% of buprenorphine/naloxone users and 0.13% of methadone users experiencing mortality during the study period (adjusted HR, 0.57). These findings indicate methadone was associated with a lower risk of treatment discontinuation, while mortality rates during treatment were similar between both medications.

The study's findings, published in JAMA, were consistent across patient subgroups and remained unchanged after the introduction of fentanyl into the illicit drug supply. These data provide further evidence of methadone's association with lower discontinuation rates, while both treatments showed comparable safety profiles regarding mortality.

Full disclosures can be found in the published study.