LAUSR

What is the problem and what is known about it so far? Opioid drugs may be harmful and even fatal if taken in too large a dose (overdose). People who have survived an opioid overdose have a higher risk for a future overdose, which may be harmful or fatal. Three types of medications are approved to help people with opioid use disorder avoid using opioids: methadone, buprenorphine, and naltrexone. Experts do not know whether using these medications after a nonfatal overdose reduces the risk for future fatal overdoses. Why did the researchers do this particular study? To determine whether treatment with methadone, buprenorphine, or naltrexone after a nonfatal opioid overdose is associated with a change in the risk for death related to opioid use or other causes. Who was studied? 17,568 adults in Massachusetts who had survived an opioid overdose between 2012 and 2014. How was the study done? The researchers used state databases that collect information on treatments for opioid use problems and overdoses. After identifying individuals who had survived an opioid overdose, they determined whether and for how long patients were treated with methadone, buprenorphine, or naltrexone. The researchers then compared the rates of death related to opioid use or other causes over the next year among patients who had received 1 or more of the drugs and those who had not. What did the researchers find? In the year after the opioid overdose, patients who were treated with either methadone or buprenorphine had a lower risk for death due to opioids or other causes compared with patients who received none of the medications for opioid use disorder. The study was not able to draw confident conclusions about naltrexone because there were not enough data about patients who used it. The researchers also noted that a minority of patients received any of the 3 drugs. What were the limitations of the study? Although the researchers took as many factors into account as possible, additional factors other than treatment with methadone, buprenorphine, and naltrexone may be associated with or cause the differences in death seen. We cannot be sure what caused the differences. What are the implications of the study? Treatment with methadone or buprenorphine after an opioid overdose is associated with a decreased risk for death in the next year. Only a minority of patients in this study had received any of these treatments. More study is needed to help make sure that patients who may benefit from treatment receive it.