Initiating medication for opioid use disorder within 7 days of hospital discharge reduced the odds of fatal and nonfatal opioid overdose by 37% at 6 months, according to new study results.

The study, published in JAMA Network Open, included 22,235 patients with opioid use disorder (OUD)-related hospital visits, investigating whether starting MOUD within 7 days of discharge was associated with a lower risk of fatal and nonfatal opioid overdose at 6 and 12 months. The study excluded patients with overdose codes at their index visit.

The study population was 53.1% female. A quarter of the patients fell within the 25-39 age range. A majority, 58.4%, had three or more Elixhauser comorbidities. The cohort included 8,345 emergency department (ED) visits and 13,890 hospitalizations. There were 452 overdose events, both nonfatal and fatal, at 6 months, and 758 overdose events at 12 months.

Led by Scott G. Weiner, MD, MPH, from Brigham and Women's Hospital, investigators found that only 5.3% of patients initiated MOUD within 7 days of their hospital or ED visit, with initiation rates varying significantly across age groups and insurance types. 

The analysis utilized data from the Oregon Comprehensive Opioid Risk Registry, encompassing individuals aged 18 years and older diagnosed with OUD between January 2017 and December 2019. Of the patients who received MOUD, 57.7% were prescribed buprenorphine, 39.1% received methadone, and 3.9% were given long-acting injectable naltrexone. Buprenorphine initiation was associated with a lower risk of overdose at 6 months (AOR, 0.50; 95% CI, 0.27-0.95). However, no significant association was found between methadone use and reduced overdose risk.

The protective effect of MOUD did not persist at 12 months, with no significant difference in the adjusted odds of overdose between those who received MOUD and those who did not (AOR, 0.79; 95% CI, 0.58-1.08).

The study had several limitations, including reliance on administrative data and potential for selection bias. 

Full disclosures can be found in the published study.