2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/2iy5wruuedsh6.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/00yc7rcvua6a7.js","/_next/static/immutable/chunks/37ktb71aq3480.js","/_next/static/immutable/chunks/2d50b-7eu4558.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/2d6noqpp6ehas.js","/_next/static/immutable/chunks/1sx186c93bpzg.js","/_next/static/immutable/chunks/3dc-1n866s65i.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2w1bvggzb0ga8.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T713,Background Opioid use can heighten pain perception over time. Aim To determine whether the effectiveness of opioid analgesia diminishes with treatment duration in those with chronic low back pain or osteoarthritis. Design and setting Systematic review (January 22, 2025) of randomized trials comparing opioids to placebo/opioid-minimized pain management strategies in those with chronic low back pain or osteoarthritis. Methods Random effects meta-analysis using MEDLINE, EMBASE, CENTRAL, and Scopus databases. OUTCOMES: Primary: Attainment of clinically important pain relief (≥ "moderate" or ≥30% improvement). Secondary: On-treatment pain (100-point scale). PRIMARY ANALYSIS: Difference in primary/secondary outcomes across short-term (≤4-weeks), intermediate-term (4-12 weeks), and long-term (≥12 weeks) subgroups. Results Twenty-seven trials were eligible for inclusion. Clinically important pain relief differed significantly between short, intermediate, and long-term treatment durations (P = 0.05). Opioid recipients were more likely to be responders in short-term trials (8 trials, RR 1.42, 95% CI 1.08 to 1.89, moderate-certainty evidence), but not in intermediate-term trials (3 trials, RR 1.04, 95% CI 0.84 to 1.30, low-certainty evidence), nor long-term trials (9 trials, RR 0.91, 95% CI 0.73 to 1.14, moderate-certainty evidence), which trended in favour of controls. The mean difference in pain scores failed to reach our definition of clinical significance (≥10-points) for any time point, but was statistically significant in the short and intermediate-term. Conclusion Although opioids likely provide meaningful pain relief over short durations (≤4 weeks), they appear to provide little or no benefit beyond placebo over longer periods, and may worsen pain control beyond 12-weeks.31:T728,Background Opioid use can heighten pain perception over time. Aim To determine whether the effectiveness of opioid analgesia diminishes with treatment duration in those with chronic low back pain or osteoarthritis. Design and setting Systematic review (January 22, 2025) of randomized trials comparing opioids to placebo/opioid-minimized pain management strategies in those with chronic low back pain or osteoarthritis. Methods Random effects meta-analysis using MEDLINE, EMBASE, CENTRAL, and Scopus databases. OUTCOMES: Primary: Attainment of clinically important pain relief (≥ “moderate” or ≥30% improvement). Secondary: On-treatment pain (100-point scale). PRIMARY ANALYSIS: Difference in primary/secondary outcomes across short-term (≤4-weeks), intermediate-term (4-12 weeks), and long-term (≥12 weeks) subgroups. Results Twenty-seven trials were eligible for inclusion. Clinically important pain relief differed significantly between short, intermediate, and long-term treatment durations (P = 0.05). Opioid recipients were more likely to be responders in short-term trials (8 trials, RR 1.42, 95% CI 1.08 to 1.89, moderate-certainty evidence), but not in intermediate-term trials (3 trials, RR 1.04, 95% CI 0.84 to 1.30, low-certainty evidence), nor long-term trials (9 trials, RR 0.91, 95% CI 0.73 to 1.14, moderate-certainty evidence), which trended in favour of controls. The mean difference in pain scores failed to reach our definition of clinical significance (≥10-points) for any time point, but was statistically significant in the short and intermediate-term. Conclusion Although opioids likely provide meaningful pain relief over short durations (≤4 weeks), they appear to provide little or no benefit beyond placebo over longer periods, and may worsen pain control beyond 12-weeks.32:T8d6,Clinicians have little guidance on the ideal length of time patients should remain on medication treatment for opioid use disorder (MOUD) before being able to safely discontinue MOUD. This study estimated how the risk of all-cause mortality changes with the duration of MOUD, controlling for patient characteristics that change the risk profile independent of duration of therapy. Retrospective cohort study using electronic health record data from the US Veterans Healthcare Administration. Veterans initiating MOUD with buprenorphine, methadone or extended-release naltrexone from October 2010 to September 2020. Our analytic sample included 19 666 buprenorphine initiators, 8675 methadone initiators and 4007 extended-release naltrexone initiators. Duration of MOUD was measured in days. Discontinuation was defined as a gap in any MOUD coverage exceeding 28 days, regardless of MOUD type initiated. The primary outcome was all-cause mortality. We estimated multistate survival models allowing for the modeling of multiple states (i.e. on and off MOUD, death) without having to consider censoring or competing events, while adjusting for sociodemographic, clinical, prescription and facility and provider characteristics. We observed approximately 226 000 person-years of time at risk for discontinuation or pre-discontinuation death, during which we observed 26 841 discontinuations (118.9 discontinuations per 1000 person-years). We similarly observed a total of about 106 000 person-years of post-discontinuation follow-up, during which we observed 3251 deaths (3.1 deaths per 1000 person-years). We found the largest marginal gain in probability of 6-year survival from an additional year on MOUD appears to occur around 2 years, as compared to 6 months on MOUD. Statistically significant gains continued through approximately 4-5 years of MOUD retention relative to 6-month MOUD retention. After 4-5 years, the marginal gain from one additional year of MOUD was not statistically significant. Among US veterans, the benefit of retention on medication treatment for opioid use disorder (MOUD) towards overall survival continues through at least 4 years of MOUD treatment. Quality metrics based on 6-month MOUD retention may be insufficient.33:Tc2f,Abstract Background and aims Clinicians have little guidance on the ideal length of time patients should remain on medication treatment for opioid use disorder (MOUD) before being able to safely discontinue MOUD. This study estimated how the risk of all‐cause mortality changes with the duration of MOUD, controlling for patient characteristics that change the risk profile independent of duration of therapy. Design, setting and participants Retrospective cohort study using electronic health record data from the US Veterans Healthcare Administration. Veterans initiating MOUD with buprenorphine, methadone or extended‐release naltrexone from October 2010 to September 2020. Our analytic sample included 19 666 buprenorphine initiators, 8675 methadone initiators and 4007 extended‐release naltrexone initiators. Measurement Duration of MOUD was measured in days. Discontinuation was defined as a gap in any MOUD coverage exceeding 28 days, regardless of MOUD type initiated. The primary outcome was all‐cause mortality. We estimated multistate survival models allowing for the modeling of multiple states (i.e. on and off MOUD, death) without having to consider censoring or competing events, while adjusting for sociodemographic, clinical, prescription and facility and provider characteristics. Findings We observed approximately 226 000 person‐years of time at risk for discontinuation or pre‐discontinuation death, during which we observed 26 841 discontinuations (118.9 discontinuations per 1000 person‐years). We similarly observed a total of about 106 000 person‐years of post‐discontinuation follow‐up, during which we observed 3251 deaths (3.1 deaths per 1000 person‐years). We found the largest marginal gain in probability of 6‐year survival from an additional year on MOUD appears to occur around 2 years, as compared to 6 months on MOUD. Statistically significant gains continued through approximately 4–5 years of MOUD retention relative to 6‐month MOUD retention. After 4–5 years, the marginal gain from one additional year of MOUD was not statistically significant. Conclusions Among US veterans, the benefit of retention on medication treatment for opioid use disorder (MOUD) towards overall survival continues through at least 4 years of MOUD treatment. Quality metrics based on 6‐month MOUD retention may be insufficient. 34:T787,It is unclear how long youth with opioid use disorder (OUD) should continue taking buprenorphine, and what adherence they should achieve. We identified patterns of duration/adherence and assessed associations with subsequent overdose, emergency department (ED) use, and hospitalization. This retrospective cohort analysis used 2014-2022 data from the Massachusetts Public Health Data Warehouse. We identified youth aged 13 to 26 years initiating buprenorphine and used group-based trajectory modeling to categorize youth into duration/adherence trajectories over 12 months. Using multivariable Cox regression, we examined associations between trajectories and time to fatal/nonfatal opioid overdose, all-cause ED use, and all-cause hospitalization during the subsequent 12-month period. Among 11 649 Massachusetts youth initiating buprenorphine, most were aged 21 years or older (89.0%), male (60.3%), white non-Hispanic (85.9%), and enrolled in Medicaid (55.4%). We identified 4 patterns of medication use: (1) high adherence for 12 months (23.7%); (2) low adherence for 12 months (27.5%); (3) discontinuation in 3 to 9 months (16.4%); and (4) discontinuation in less than 3 months (32.5%). Trajectories included 580 (5.0%) and 774 (6.6%) youth switching to methadone and naltrexone, respectively. Compared with high adherence for 12 months, overdose risk was higher with low adherence for 12 months (adjusted hazard ratio [aHR], 1.46; 95% CI, 1.24-1.73), discontinuation in 3 to 9 months (aHR, 1.82; 95% CI, 1.52-2.17), and discontinuation in less than 3 months (aHR, 1.76; 95% CI 1.50-2.06). Compared with high adherence, low adherence and discontinuation in less than 3 months had higher risk of ED use, and all other trajectories had higher risk of hospitalization. Medication adherence may prevent overdose, ED use, and hospitalization. Strategies to increase treatment duration/adherence likely avert harm.35:Ta35, OBJECTIVES It is unclear how long youth with opioid use disorder (OUD) should continue taking buprenorphine, and what adherence they should achieve. We identified patterns of duration/adherence and assessed associations with subsequent overdose, emergency department (ED) use, and hospitalization. METHODS This retrospective cohort analysis used 2014–2022 data from the Massachusetts Public Health Data Warehouse. We identified youth aged 13 to 26 years initiating buprenorphine and used group-based trajectory modeling to categorize youth into duration/adherence trajectories over 12 months. Using multivariable Cox regression, we examined associations between trajectories and time to fatal/nonfatal opioid overdose, all-cause ED use, and all-cause hospitalization during the subsequent 12-month period. RESULTS Among 11 649 Massachusetts youth initiating buprenorphine, most were aged 21 years or older (89.0%), male (60.3%), white non-Hispanic (85.9%), and enrolled in Medicaid (55.4%). We identified 4 patterns of medication use: (1) high adherence for 12 months (23.7%); (2) low adherence for 12 months (27.5%); (3) discontinuation in 3 to 9 months (16.4%); and (4) discontinuation in less than 3 months (32.5%). Trajectories included 580 (5.0%) and 774 (6.6%) youth switching to methadone and naltrexone, respectively. Compared with high adherence for 12 months, overdose risk was higher with low adherence for 12 months (adjusted hazard ratio [aHR], 1.46; 95% CI, 1.24–1.73), discontinuation in 3 to 9 months (aHR, 1.82; 95% CI, 1.52–2.17), and discontinuation in less than 3 months (aHR, 1.76; 95% CI 1.50–2.06). Compared with high adherence, low adherence and discontinuation in less than 3 months had higher risk of ED use, and all other trajectories had higher risk of hospitalization. CONCLUSIONS Medication adherence may prevent overdose, ED use, and hospitalization. Strategies to increase treatment duration/adherence likely avert harm. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"buprenorphine: generic Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on buprenorphine (generic). Clinician-written summaries and actionable practice insights. 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key quantitative results, sample size, follow-up duration, and specific disparity estimates cannot be extracted or verified.","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.2506","tag_type":"warning","value":"The DOI publication date (2026-08-19) is one day before today's date, suggesting this is a very recently published article — full text may not yet be widely accessible.","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.2506","tag_type":"warning","value":"The impact flag 'safety_signal' was applied given the public health significance of treatment discontinuation disparities in a vulnerable perinatal population, but clinical severity cannot be confirmed without full text.","value_numeric":null}],"summaries":{"practice_takeaway":"Clinicians treating pregnant patients with OUD should be aware that racial and ethnic disparities in treatment retention may exist, warranting targeted support strategies for at-risk groups.","what_studied":"This cohort study evaluated racial and ethnic disparities in retention in buprenorphine and methadone treatment among pregnant females with opioid use disorder (OUD) in the US.","limitations":"The abstract provides insufficient detail to assess specific limitations such as sample size, follow-up duration, confounders adjusted for, or outcome definitions."}},{"doi":"10.1002/acr.80114","pmid":"42439302","title":"Opioid Use Disorder and Treatment Uptake Among Patients With Rheumatic Conditions in the\n All of Us\n Research Program: A Descriptive Analysis","journal_title":"Arthritis Care & Research","journal_issn":"2151-464X","published_at":"2026-08-02T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13367410/","source_score":26,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-11T06:19:59.463Z","updated_at":"2026-09-11T06:19:59.463Z","tags":[{"paper_doi":"10.1002/acr.80114","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/acr.80114","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1002/acr.80114","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1002/acr.80114","tag_type":"condition","value":"Opioid Use Disorder","value_numeric":null},{"paper_doi":"10.1002/acr.80114","tag_type":"condition","value":"Osteoarthritis","value_numeric":null},{"paper_doi":"10.1002/acr.80114","tag_type":"condition","value":"Rheumatoid Arthritis","value_numeric":null},{"paper_doi":"10.1002/acr.80114","tag_type":"condition","value":"Spondyloarthritis","value_numeric":null},{"paper_doi":"10.1002/acr.80114","tag_type":"condition","value":"Systemic Lupus Erythematosus","value_numeric":null},{"paper_doi":"10.1002/acr.80114","tag_type":"generic","value":"buprenorphine","value_numeric":null},{"paper_doi":"10.1002/acr.80114","tag_type":"generic","value":"methadone","value_numeric":null},{"paper_doi":"10.1002/acr.80114","tag_type":"generic","value":"naltrexone","value_numeric":null},{"paper_doi":"10.1002/acr.80114","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1002/acr.80114","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1002/acr.80114","tag_type":"modality","value":"Disease-Modifying Antirheumatic Drug","value_numeric":null},{"paper_doi":"10.1002/acr.80114","tag_type":"modality","value":"Opioid Use Disorder Pharmacotherapy","value_numeric":null},{"paper_doi":"10.1002/acr.80114","tag_type":"sample_size","value":"n=37282","value_numeric":37282},{"paper_doi":"10.1002/acr.80114","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/acr.80114","tag_type":"study_design","value":"Cross-Sectional Descriptive Study","value_numeric":null},{"paper_doi":"10.1002/acr.80114","tag_type":"warning","value":"Geographic overrepresentation of the West U.S. Census Region in the OUD group may limit generalizability.","value_numeric":null},{"paper_doi":"10.1002/acr.80114","tag_type":"warning","value":"MOUD uptake figures may be slightly overestimated as methadone/buprenorphine/naltrexone can be prescribed for pain or other substance disorders, not exclusively OUD.","value_numeric":null},{"paper_doi":"10.1002/acr.80114","tag_type":"warning","value":"OUD billing code sensitivity is only 59%, so true OUD prevalence may be higher than reported 4.0%.","value_numeric":null},{"paper_doi":"10.1002/acr.80114","tag_type":"warning","value":"Study design is cross-sectional/descriptive using EHR billing codes; causality and directionality cannot be established.","value_numeric":null}],"summaries":{"what_studied":"This descriptive analysis used the national *All of Us* Research Program (2015–2023, n=37,282) to characterize patients with OA, SLE, RA, or SpA who also had opioid use disorder (OUD), and to measure uptake of medications for OUD (MOUD: buprenorphine, methadone, naltrexone) after first OUD diagnosis.","key_result":"4.0% of rheumatic disease patients had OUD (n=1,502). Those with OUD were younger (mean 57.5 vs 63.7 years), had higher Medicaid enrollment (50.7% vs 22.9%), more psychiatric comorbidities, higher prior opioid exposure (75.7% vs 45.8%), more corticosteroid use, and lower DMARD use (biologic/targeted synthetic: 3.2% vs 4.7%; conventional: 7.5% vs 10.0%). Only 14.5% of eligible patients with OUD received MOUD — well below the national estimate of ~25%.","limitations":"- OUD identified by billing codes only (PPV 64–80%, sensitivity 59%), so active vs. historical OUD cannot be distinguished.\n- Small subgroup sizes prevented analysis of social risk factors and detailed substance-type breakdowns.\n- MOUD may be used for pain or other substance disorders, potentially overestimating true OUD treatment uptake.","practice_takeaway":"Rheumatologists should routinely screen for OUD in patients with SLE, RA, SpA, and OA — especially those on chronic opioids or corticosteroids — and facilitate MOUD access, as fewer than 1 in 7 affected patients currently receives treatment. Lower DMARD use in patients with OUD suggests unmet disease management needs that may compound OUD-related morbidity."}},{"doi":"10.1111/add.70510","pmid":"42478226","title":"Prenatal opioid exposure, and health, social and educational outcomes for school‐aged children: A systematic review","journal_title":"Addiction","journal_issn":"0965-2140","published_at":"2026-07-21T00:00:00.000Z","url":"https://doi.org/10.1111/add.70510","source_score":12,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-31T13:37:07.115Z","updated_at":"2026-07-31T13:37:07.115Z","tags":[{"paper_doi":"10.1111/add.70510","tag_type":"age_group","value":"adolescent","value_numeric":null},{"paper_doi":"10.1111/add.70510","tag_type":"age_group","value":"child","value_numeric":null},{"paper_doi":"10.1111/add.70510","tag_type":"category","value":"Psychiatry","value_numeric":null},{"paper_doi":"10.1111/add.70510","tag_type":"condition","value":"Attention-Deficit/Hyperactivity Disorder","value_numeric":null},{"paper_doi":"10.1111/add.70510","tag_type":"condition","value":"Neonatal Opioid Withdrawal Syndrome","value_numeric":null},{"paper_doi":"10.1111/add.70510","tag_type":"condition","value":"Opioid Use Disorder","value_numeric":null},{"paper_doi":"10.1111/add.70510","tag_type":"condition","value":"Prenatal Opioid Exposure","value_numeric":null},{"paper_doi":"10.1111/add.70510","tag_type":"condition","value":"Visual Impairment","value_numeric":null},{"paper_doi":"10.1111/add.70510","tag_type":"generic","value":"buprenorphine","value_numeric":null},{"paper_doi":"10.1111/add.70510","tag_type":"generic","value":"methadone","value_numeric":null},{"paper_doi":"10.1111/add.70510","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1111/add.70510","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1111/add.70510","tag_type":"modality","value":"Opioid Agonist Therapy","value_numeric":null},{"paper_doi":"10.1111/add.70510","tag_type":"sample_size","value":"n=5461376","value_numeric":5461376},{"paper_doi":"10.1111/add.70510","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/add.70510","tag_type":"study_design","value":"Systematic Review","value_numeric":null},{"paper_doi":"10.1111/add.70510","tag_type":"warning","value":"Adolescent outcomes (ages 13–18) are almost entirely absent from the evidence base, limiting generalizability across the full stated age range.","value_numeric":null},{"paper_doi":"10.1111/add.70510","tag_type":"warning","value":"Most included studies are observational with significant confounding risks (e.g., poverty, polydrug exposure, caregiving instability); causal inference is not established.","value_numeric":null},{"paper_doi":"10.1111/add.70510","tag_type":"warning","value":"Sample size tag combines exposed children (31,104) and controls (5,430,272) into a total; these are very different populations and the combined N may be misleading when interpreting study power for the exposed group alone.","value_numeric":null},{"paper_doi":"10.1111/add.70510","tag_type":"warning","value":"The review includes both illicit opioid exposure and MOUD (methadone, buprenorphine) without ability to fully separate their individual effects in the narrative synthesis.","value_numeric":null}],"summaries":{"what_studied":"This systematic review examined the association between prenatal opioid exposure (POE) — from illicit opioids or medication for opioid use disorder (MOUD) — and health, social, and educational outcomes in school-aged children (ages 5–18 years), drawing from studies published January 2015 to October 2025.","key_result":"Across 27 included papers (16 studies; 31,104 exposed children vs. 5,430,272 controls), POE was most consistently linked to poorer visual outcomes (4/4 studies), increased hyperactivity and inattention (3/3 studies), and cognitive difficulties (7/10 studies); findings for physical health and brain structure were inconclusive.","limitations":"- High or very high risk of bias in 17/32 papers, mainly due to longitudinal attrition and inadequate confounding control.\n- Evidence base is thin for each domain, often with small participant numbers.\n- Nearly all research covers ages 5–12; adolescent outcomes are largely unstudied.","practice_takeaway":"Children with prenatal opioid exposure should be monitored for visual problems, attention/hyperactivity, and cognitive difficulties from school entry onward. Routine ophthalmologic and neurodevelopmental screening in this population is supported by the current evidence."}},{"doi":"10.1111/add.70482","pmid":"42309510","title":"Barriers and facilitators to detoxification from opioid substitution treatment: A mixed‐methods systematic review","journal_title":"Addiction","journal_issn":"0965-2140","published_at":"2026-06-17T00:00:00.000Z","url":"https://doi.org/10.1111/add.70482","source_score":37,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-24T13:21:42.880Z","updated_at":"2026-06-24T13:21:42.880Z","tags":[{"paper_doi":"10.1111/add.70482","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1111/add.70482","tag_type":"category","value":"Psychiatry","value_numeric":null},{"paper_doi":"10.1111/add.70482","tag_type":"condition","value":"Opioid Dependence","value_numeric":null},{"paper_doi":"10.1111/add.70482","tag_type":"condition","value":"Opioid Use Disorder","value_numeric":null},{"paper_doi":"10.1111/add.70482","tag_type":"generic","value":"buprenorphine","value_numeric":null},{"paper_doi":"10.1111/add.70482","tag_type":"generic","value":"methadone","value_numeric":null},{"paper_doi":"10.1111/add.70482","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1111/add.70482","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1111/add.70482","tag_type":"modality","value":"Opioid Substitution Treatment","value_numeric":null},{"paper_doi":"10.1111/add.70482","tag_type":"sample_size","value":"n=41","value_numeric":41},{"paper_doi":"10.1111/add.70482","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/add.70482","tag_type":"study_design","value":"Mixed-Methods Systematic Review","value_numeric":null},{"paper_doi":"10.1111/add.70482","tag_type":"warning","value":"Age and sex distributions of participants across included studies are not reported in the abstract; age_group and sex tags are inferred from the adult opioid dependence context.","value_numeric":null},{"paper_doi":"10.1111/add.70482","tag_type":"warning","value":"Study quality was mixed: 54% high quality and 37% medium quality; findings should be interpreted with this heterogeneity in mind.","value_numeric":null},{"paper_doi":"10.1111/add.70482","tag_type":"warning","value":"The sample size tag reflects the number of included studies (n=41), not individual participants — total patient numbers are not reported in the abstract.","value_numeric":null}],"summaries":{"what_studied":"This mixed-methods systematic review examined barriers and facilitators to detoxification (gradual OST dose reduction to zero) among people with opioid dependence, synthesizing 41 studies across qualitative, quantitative, and mixed-methods designs published up to January 2025.","key_result":"Eight themes emerged: psychological/emotional factors (especially fear of detoxification), personal motivation, withdrawal symptoms, clinical/demographic factors, environmental factors, social factors, professional support, and treatment models. Key barriers included fear, emotional resurgence, low confidence, environmental instability, and negative social influences; key facilitators included psychological readiness, life stability, supportive relationships, psychological interventions, inpatient settings, and adjunctive medications.","limitations":"- Most studies (22/41) originated from the USA, limiting geographic generalizability.\n- Only 1 study focused solely on treatment providers, leaving the clinician perspective largely absent.\n- Studies of purely pharmacological interventions were excluded, which may omit relevant outcome data.","practice_takeaway":"Clinicians supporting OST patients who want to detoxify should proactively address fear and emotional readiness, and consider inpatient settings or adjunctive medications for those lacking stable social environments. Psychological interventions and structured professional support appear to be key modifiable facilitators of successful detoxification."}},{"doi":"10.1097/pec.0000000000003640","pmid":"42299025","title":"Improving Naloxone and Buprenorphine Provision in the Pediatric Emergency Department Through Education and Chief Complaint-Triggered Screening","journal_title":"Pediatric Emergency Care","journal_issn":"0749-5161","published_at":"2026-06-16T00:00:00.000Z","url":"https://doi.org/10.1097/pec.0000000000003640","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-20T13:24:59.796Z","updated_at":"2026-06-20T13:24:59.796Z","tags":[{"paper_doi":"10.1097/pec.0000000000003640","tag_type":"age_group","value":"adolescent","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003640","tag_type":"category","value":"Emergency Medicine","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003640","tag_type":"condition","value":"Opioid Overdose","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003640","tag_type":"condition","value":"Opioid Use Disorder","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003640","tag_type":"generic","value":"buprenorphine","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003640","tag_type":"generic","value":"naloxone","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003640","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003640","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003640","tag_type":"modality","value":"Opioid Antagonist","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003640","tag_type":"modality","value":"Partial Opioid Agonist","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003640","tag_type":"sample_size","value":"n=309","value_numeric":309},{"paper_doi":"10.1097/pec.0000000000003640","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003640","tag_type":"study_design","value":"Quality Improvement Study","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003640","tag_type":"warning","value":"Sample size of 309 reflects medication recipients only, not total encounters analyzed over 45 months; the denominator for all PED visits is not reported in the abstract.","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003640","tag_type":"warning","value":"Study design is labeled QI (quality improvement), which lacks a concurrent control group; pre-post comparisons may be subject to secular trend bias.","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003640","tag_type":"warning","value":"The full text was not accessible — only the abstract was available for extraction. Statistical significance, confidence intervals, and detailed demographic breakdowns could not be verified.","value_numeric":null},{"paper_doi":"10.1097/pec.0000000000003640","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously given the single-site, non-randomized design, but the intervention represents a scalable, EHR-integrated model with clear outcome improvements.","value_numeric":null}],"summaries":{"practice_takeaway":"Embedding chief complaint–triggered electronic alerts with provider education in a PED can meaningfully raise naloxone and buprenorphine provision for at-risk adolescents without driving more return visits. EDs caring for adolescents should consider implementing similar BPA-driven OUD screening pathways.","what_studied":"This quality improvement (QI) initiative evaluated whether electronic Best Practice Alerts (BPAs) triggered by specific chief complaints — combined with provider education, formulary changes, and clinical pathways — could increase naloxone dispensing and buprenorphine prescribing for adolescents with opioid use disorder (OUD) in a pediatric emergency department (PED) over a 45-month period.","key_result":"Among patients with BPA-qualifying chief complaints, naloxone dispensing rose from 3.89% to 11.39% and buprenorphine prescribing rose from 1.04% to 2.46% post-implementation; overall naloxone prescribing across all PED visits increased from 0.40% to 0.79%. In total, 63 adolescents initiated buprenorphine and 246 received naloxone. Black/African American adolescents and those with government insurance received more medications post-implementation. BPA-triggered encounters had longer ED stays but no increase in return visits.","limitations":"Single-site QI study limits generalizability. The full-text was not accessible for review — findings are drawn from the abstract alone, so confounders and statistical significance details are unavailable. Absolute prescribing rates remain low even post-intervention, suggesting substantial room for improvement."}},{"doi":"10.1176/appi.ajp.20250840","pmid":"42151794","title":"Low-Dose Buprenorphine Following Ketamine Treatment for Suicidal Ideation in Major Depressive Disorder: A Randomized, Double-Blind, Placebo-Controlled Trial","journal_title":"American Journal of Psychiatry","journal_issn":"0002-953X","published_at":"2026-05-19T00:00:00.000Z","url":"https://doi.org/10.1176/appi.ajp.20250840","source_score":71,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-24T13:23:14.539Z","updated_at":"2026-05-24T13:23:14.539Z","tags":[{"paper_doi":"10.1176/appi.ajp.20250840","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250840","tag_type":"category","value":"Psychiatry","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250840","tag_type":"condition","value":"Major Depressive Disorder","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250840","tag_type":"condition","value":"Suicidal Ideation","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250840","tag_type":"generic","value":"buprenorphine","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250840","tag_type":"generic","value":"ketamine","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250840","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250840","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250840","tag_type":"modality","value":"NMDA Receptor Antagonist","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250840","tag_type":"modality","value":"Opioid Partial Agonist","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250840","tag_type":"sample_size","value":"n=50","value_numeric":50},{"paper_doi":"10.1176/appi.ajp.20250840","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250840","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250840","tag_type":"warning","value":"68% female sample may limit generalizability across sexes.","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250840","tag_type":"warning","value":"Ketamine was administered open-label, introducing potential expectation bias prior to the blinded phase.","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250840","tag_type":"warning","value":"Sample size is small (N=50 randomized, N=45 analyzed), which may inflate effect size estimates — interpret Glass Δ with caution.","value_numeric":null},{"paper_doi":"10.1176/appi.ajp.20250840","tag_type":"warning","value":"The 'practice_changing' impact flag reflects the novelty of the finding as the first RCT of its kind, but should be tempered by the single-center design and short follow-up.","value_numeric":null}],"summaries":{"what_studied":"This RCT tested whether low-dose sublingual buprenorphine (0.2–0.8 mg/day × 4 weeks) versus placebo, started 48 hours after a single IV ketamine infusion (0.5 mg/kg over 40 min), could sustain the antisuicidal effects of ketamine in adults with MDD and active suicidal ideation (SSI score ≥6).","key_result":"Buprenorphine produced a significantly greater reduction in SSI total score vs. placebo (mean change −11.6 vs. −6.3; Glass Δ=0.76, 95% CI 0.11–1.39; time-by-treatment interaction p<0.001) over 4 weeks, with no serious treatment-related adverse events. Depression scores did not differ significantly between groups.","limitations":"- Single-center trial with a small sample (N=50 randomized; N=45 analyzed), limiting generalizability.\n- Open-label ketamine administration may have introduced expectation bias before blinded follow-on treatment.\n- No active comparator; long-term safety and durability beyond 4 weeks are unknown.","practice_takeaway":"For adults with MDD and suicidal ideation who receive IV ketamine, adding low-dose sublingual buprenorphine starting 48 hours post-infusion may meaningfully extend the antisuicidal benefit for at least 4 weeks. Larger, multi-site trials are needed before broad adoption, but the absence of serious adverse events is reassuring."}},{"doi":"10.1080/10903127.2026.2668009","pmid":"42114053","title":"The Role of Emergency Medical Services in Addressing Opioid Use Disorder – A Position Statement and Resource Document of NAEMSP","journal_title":"Prehospital Emergency Care","journal_issn":"1090-3127","published_at":"2026-05-11T00:00:00.000Z","url":"https://doi.org/10.1080/10903127.2026.2668009","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-18T13:25:33.074Z","updated_at":"2026-05-18T13:25:33.074Z","tags":[{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"brand","value":"Narcan","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"category","value":"Emergency Medicine","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"condition","value":"Opioid Overdose","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"condition","value":"Opioid Use Disorder","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"generic","value":"buprenorphine","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"generic","value":"naloxone","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"modality","value":"Opioid Antagonist","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"modality","value":"Partial Opioid Agonist","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"study_design","value":"Position Statement / Consensus Guideline","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"warning","value":"Brand tag 'Narcan' added as the most recognized naloxone brand, though the paper does not explicitly name it — other naloxone formulations exist.","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"warning","value":"The age group tag defaults to 'adult' as the paper does not specify pediatric populations, though OUD can affect adolescents as well.","value_numeric":null},{"paper_doi":"10.1080/10903127.2026.2668009","tag_type":"warning","value":"This is an expert consensus position statement, not an original clinical trial — level of evidence reflects opinion/guideline rather than experimental data.","value_numeric":null}],"summaries":{"what_studied":"This NAEMSP position statement evaluates the role of EMS in addressing opioid use disorder (OUD), covering harm reduction, prehospital medications for OUD (MOUD), alternate dispositions, naloxone distribution, and clinician education.","key_result":"NAEMSP recommends EMS agencies establish low-barrier protocols for prehospital buprenorphine administration, integrate community harm-reduction resources, support alternate patient destinations, expand naloxone distribution, and deliver comprehensive anti-stigma education for EMS clinicians.","limitations":"This is a position statement rather than an original study — recommendations are based on existing evidence synthesis without new primary data or formal meta-analysis. Implementation feasibility may vary widely by local EMS system scope-of-practice laws and resources.","practice_takeaway":"EMS medical directors should work now to authorize buprenorphine in prehospital protocols and connect overdose patients to treatment rather than defaulting to ED transport. Harm-reduction strategies like naloxone distribution and stigma-focused training should be standard across EMS systems."}},{"doi":"10.3399/bjgp.2025.0705","pmid":"42097637","title":"Impact of Treatment Duration on the Effectiveness of Opioid Analgesia: A Systematic Review and Meta-Analysis","journal_title":"British Journal of General Practice","journal_issn":"0960-1643","published_at":"2026-05-08T00:00:00.000Z","url":"https://doi.org/10.3399/bjgp.2025.0705","source_score":2,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-05-09","doi":"10.3399/bjgp.2025.0705","days":"7","issn":"0960-1643","rank":"10","field":"Clinical Medicine","score":"2","category":"Primary Health Care","categories":["Primary Health Care"],"_categories":["Primary Health Care"]},"pubmed":{"doi":"10.3399/BJGP.2025.0705","title":"Impact of Treatment Duration on the Effectiveness of Opioid Analgesia: A Systematic Review and Meta-Analysis.","journal":"The British journal of general practice : the journal of the Royal College of General Practitioners","methods":"","results":"","abstract":"$30","keywords":["Chronic Pain","Opioid","Osteoarthritis"],"pubmed_id":"42097637","conclusions":"","publication_date":"2026-05-08T00:00:00"},"crossref":{"DOI":"10.3399/bjgp.2025.0705","URL":"https://doi.org/10.3399/bjgp.2025.0705","ISSN":["0960-1643","1478-5242"],"link":[{"URL":"https://syndication.highwire.org/content/doi/10.3399/BJGP.2025.0705","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"BJGP.2025.0705","type":"journal-article","issue":null,"score":1,"title":["Impact of Treatment Duration on the Effectiveness of Opioid Analgesia: A Systematic Review and Meta-Analysis"],"author":[{"given":"Liesbeth","family":"Froentjes","sequence":"first","affiliation":[]},{"given":"Catherine","family":"Barrington","sequence":"additional","affiliation":[]},{"given":"Rodger","family":"Craig","sequence":"additional","affiliation":[]},{"given":"Mareiz","family":"Morcos","sequence":"additional","affiliation":[]},{"given":"Dawn","family":"Wedman","sequence":"additional","affiliation":[]},{"given":"Christina","family":"Korowynk","sequence":"additional","affiliation":[]},{"given":"Michael Daniel","family":"Kelmer","sequence":"additional","affiliation":[]},{"given":"Farah","family":"Campbell","sequence":"additional","affiliation":[]},{"given":"Scott R","family":"Garrison","sequence":"additional","affiliation":[]}],"issued":{"date-parts":[[2026,5,7]]},"member":"1987","prefix":"10.3399","source":"Crossref","volume":null,"created":{"date-time":"2026-05-07T11:25:13Z","timestamp":1778153113000,"date-parts":[[2026,5,7]]},"indexed":{"date-time":"2026-05-07T12:11:03Z","timestamp":1778155863342,"date-parts":[[2026,5,7]]},"subject":[],"abstract":"$31","accepted":{"date-parts":[[2026,3,27]]},"language":"en","relation":{},"resource":{"primary":{"URL":"http://bjgp.org/lookup/doi/10.3399/BJGP.2025.0705"}},"subtitle":[],"deposited":{"date-time":"2026-05-07T11:25:14Z","timestamp":1778153114000,"date-parts":[[2026,5,7]]},"issn-type":[{"type":"print","value":"0960-1643"},{"type":"electronic","value":"1478-5242"}],"published":{"date-parts":[[2026,5,7]]},"publisher":"Royal College of General Practitioners","reference":null,"short-title":[],"alternative-id":["10.3399/BJGP.2025.0705"],"content-domain":{"domain":[],"crossmark-restriction":false},"original-title":[],"container-title":["British Journal of General Practice"],"reference-count":0,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2026,5,7]]},"references-count":0,"short-container-title":["Br J Gen Pract"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.3399/bjgp.2025.0705","is_oa":true,"title":"Impact of Treatment Duration on the Effectiveness of Opioid Analgesia: A Systematic Review and Meta-Analysis","updated":"2026-05-09T14:24:07+00:00","published_date":"2026-05-07","best_oa_location":{"url":"https://bjgp.org/content/bjgp/early/2026/05/06/BJGP.2025.0705.full.pdf","pmh_id":null,"url_for_pdf":"https://bjgp.org/content/bjgp/early/2026/05/06/BJGP.2025.0705.full.pdf","url_for_landing_page":"https://doi.org/10.3399/bjgp.2025.0705"}}},"created_at":"2026-05-14T13:23:05.165Z","updated_at":"2026-05-14T15:13:26.918Z","tags":[{"paper_doi":"10.3399/bjgp.2025.0705","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0705","tag_type":"category","value":"Primary Health Care","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0705","tag_type":"condition","value":"Chronic Low Back Pain","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0705","tag_type":"condition","value":"Osteoarthritis","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0705","tag_type":"generic","value":"buprenorphine","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0705","tag_type":"generic","value":"fentanyl","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0705","tag_type":"generic","value":"morphine","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0705","tag_type":"generic","value":"oxycodone","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0705","tag_type":"generic","value":"oxymorphone","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0705","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0705","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0705","tag_type":"modality","value":"Opioid Analgesic","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0705","tag_type":"sample_size","value":"n=27","value_numeric":27},{"paper_doi":"10.3399/bjgp.2025.0705","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0705","tag_type":"study_design","value":"Systematic Review and Meta-Analysis","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0705","tag_type":"warning","value":"Age and sex distribution were not specified.","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0705","tag_type":"warning","value":"Mean participant age was 57.3 years with 57.5% female; generalizability to younger populations or males specifically is uncertain.","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0705","tag_type":"warning","value":"Participant numbers were not reported in the abstract.","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0705","tag_type":"warning","value":"Sample size tag reflects number of trials (n=27), not individual participants; total participant counts vary by subgroup analysis (e.g., 1,700 in short-term responder analysis, 3,345 in long-term).","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0705","tag_type":"warning","value":"Subgroup counts refer to trials, not patients; intermediate-term evidence is limited to 3 trials.","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0705","tag_type":"warning","value":"The EERW trial design sensitivity analysis was limited to long-term (≥12 week) trials; findings on EERW bias may not generalize to shorter durations.","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0705","tag_type":"warning","value":"Tramadol and tapentadol were explicitly excluded due to dual mechanisms of action; findings do not apply to these agents.","value_numeric":null}],"summaries":{"what_studied":"A systematic review and random-effects meta-analysis of randomized trials (search to January 22, 2025) comparing opioids with placebo or opioid-minimized strategies for chronic low back pain or osteoarthritis, grouped by treatment duration (≤4 weeks, 4–12 weeks, ≥12 weeks). Outcomes were clinically important pain relief (≥ “moderate” or ≥30% improvement) and on-treatment pain on a 100-point scale.","key_result":"Across 27 trials, clinically important pain relief varied by duration (P=0.05): opioids increased responder rates only in short-term trials (8 trials; RR 1.42, 95% CI 1.08–1.89; moderate-certainty), not in intermediate-term (3 trials; RR 1.04, 95% CI 0.84–1.30; low-certainty) or long-term (9 trials; RR 0.91, 95% CI 0.73–1.14; moderate-certainty, trending toward controls). Mean pain score differences were statistically significant only at short and intermediate terms and never met the ≥10/100 clinical threshold at any time point.","limitations":"The intermediate-term subgroup was based on only 3 trials with low-certainty evidence.","practice_takeaway":"If opioids are used for chronic low back pain or osteoarthritis, keep courses short (≤4 weeks), when benefit is most likely. Expect little or no added pain relief beyond 4–12 weeks and ≥12 weeks, and plan management accordingly."}},{"doi":"10.1111/add.70211","pmid":"41501983","title":"Evaluating the optimal duration of medication treatment for opioid use disorder","journal_title":"Addiction","journal_issn":"0965-2140","published_at":"2026-01-08T00:00:00.000Z","url":"https://doi.org/10.1111/add.70211","source_score":31,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-14","doi":"10.1111/add.70211","days":"7","issn":"0965-2140","rank":"6","field":"Clinical Medicine","score":"31","category":"Psychiatry","categories":["Psychiatry"],"_categories":["Psychiatry"]},"pubmed":{"doi":"10.1111/add.70211","title":"Evaluating the optimal duration of medication treatment for opioid use disorder.","journal":"Addiction (Abingdon, England)","methods":"","results":"","abstract":"$32","keywords":["duration of therapy","medication treatment for opioid use disorder","mortality","multistate survival analysis","opioid use disorder","veterans"],"pubmed_id":"41501983","conclusions":"","publication_date":"2026-01-08T00:00:00"},"crossref":{"DOI":"10.1111/add.70211","URL":"https://doi.org/10.1111/add.70211","ISSN":["0965-2140","1360-0443"],"link":[{"URL":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/add.70211","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://onlinelibrary.wiley.com/doi/full-xml/10.1111/add.70211","content-type":"application/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/add.70211","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Evaluating the optimal duration of medication treatment for opioid use disorder"],"author":[{"given":"Corey J.","family":"Hayes","sequence":"first","affiliation":[{"name":"Division of Pharmaceutical Evaluation and Policy, College of Pharmacy University of Arkansas for Medical Sciences Little Rock AR USA"},{"name":"Department of Biomedical Informatics, College of Medicine University of Arkansas for Medical Sciences Little Rock AR USA"},{"name":"Institute for Digital Health and Innovation, College of Medicine University of Arkansas for Medical Sciences Little Rock AR USA"},{"name":"Center for Mental Healthcare and Outcomes Research Central Arkansas Veterans Healthcare System North Little Rock AR USA"}]},{"given":"Rebecca A.","family":"Raciborski","sequence":"additional","affiliation":[{"name":"Center for Mental Healthcare and Outcomes Research Central Arkansas Veterans Healthcare System North Little Rock AR USA"},{"name":"Behavioral Health Quality Enhancement Research Initiative Central Arkansas Veterans Healthcare System North Little Rock AR USA"},{"name":"Evidence, Policy, and Implementation Center Central Arkansas Veterans Healthcare System North Little Rock AR USA"}]},{"given":"Mahip","family":"Acharya","sequence":"additional","affiliation":[{"name":"Institute for Digital Health and Innovation, College of Medicine University of Arkansas for Medical Sciences Little Rock AR USA"},{"name":"Department of Obstetrics and Gynecology, College of Medicine University of Arkansas for Medical Sciences Little Rock AR USA"}]},{"given":"Nahiyan Bin","family":"Noor","sequence":"additional","affiliation":[{"name":"Institute for Digital Health and Innovation, College of Medicine University of Arkansas for Medical Sciences Little Rock AR USA"}]},{"given":"Edward V.","family":"Nunes","sequence":"additional","affiliation":[{"name":"Division on Substance Use Disorders, Department of Psychiatry Columbia University Irving Medical Center New York NY USA"}]},{"given":"T. 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Study","value_numeric":null},{"paper_doi":"10.1111/add.70211","tag_type":"warning","value":"Absolute effect sizes for survival gains by duration were not reported beyond trend statements.","value_numeric":null},{"paper_doi":"10.1111/add.70211","tag_type":"warning","value":"Findings are from US Veterans Health Administration patients and may not generalize to other settings.","value_numeric":null},{"paper_doi":"10.1111/add.70211","tag_type":"warning","value":"Study design and adjustments are based on the abstract; full methodological details were not assessed.","value_numeric":null}],"summaries":{"what_studied":"Retrospective cohort of US Veterans Health Administration patients initiating buprenorphine, methadone, or extended-release naltrexone (2010–2020), evaluating how all-cause mortality varies with days on MOUD. Discontinuation was a >28-day gap; multistate survival models adjusted for sociodemographic, clinical, prescription, and facility/provider factors.","key_result":"During ~226,000 person-years before discontinuation, 26,841 discontinuations occurred (118.9 per 1000 person-years); during ~106,000 post-discontinuation person-years, 3,251 deaths occurred (3.1 per 1000 person-years). The largest marginal gain in 6-year survival from one additional year on MOUD occurred around 2 years versus 6 months, with statistically significant gains through ~4–5 years; beyond 4–5 years, the marginal gain was not statistically significant.","practice_takeaway":"Retaining patients on MOUD for several years confers continued survival benefit, persisting through at least 4 years. Quality measures focused on 6-month retention may underestimate the benefit of longer retention."}},{"doi":"10.1542/peds.2025-071147","pmid":"41248890","title":"Buprenorphine Treatment Duration and Adherence Among Youth and Subsequent Health Outcomes","journal_title":"Pediatrics","journal_issn":"0031-4005","published_at":"2025-11-18T00:00:00.000Z","url":"https://www.ncbi.nlm.nih.gov/pmc/articles/12662019","source_score":179,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-11-22","doi":"10.1542/peds.2025-071147","days":"14","issn":"0031-4005","rank":"5","field":"Clinical Medicine","score":"179","category":"Pediatrics","categories":["Pediatrics"],"_categories":["Pediatrics"]},"pubmed":{"doi":"10.1542/peds.2025-071147","title":"Buprenorphine Treatment Duration and Adherence Among Youth and Subsequent Health Outcomes.","journal":"Pediatrics","methods":"","results":"Among 11 649 Massachusetts youth initiating buprenorphine, most were aged 21 years or older (89.0%), male (60.3%), white non-Hispanic (85.9%), and enrolled in Medicaid (55.4%). We identified 4 patterns of medication use: (1) high adherence for 12 months (23.7%); (2) low adherence for 12 months (27.5%); (3) discontinuation in 3 to 9 months (16.4%); and (4) discontinuation in less than 3 months (32.5%). Trajectories included 580 (5.0%) and 774 (6.6%) youth switching to methadone and naltrexone, respectively. Compared with high adherence for 12 months, overdose risk was higher with low adherence for 12 months (adjusted hazard ratio [aHR], 1.46; 95% CI, 1.24-1.73), discontinuation in 3 to 9 months (aHR, 1.82; 95% CI, 1.52-2.17), and discontinuation in less than 3 months (aHR, 1.76; 95% CI 1.50-2.06). Compared with high adherence, low adherence and discontinuation in less than 3 months had higher risk of ED use, and all other trajectories had higher risk of hospitalization.","abstract":"$34","keywords":[],"pubmed_id":"41248890","conclusions":"","publication_date":"2025-11-18T00:00:00"},"crossref":{"DOI":"10.1542/peds.2025-071147","URL":"https://doi.org/10.1542/peds.2025-071147","ISSN":["0031-4005","1098-4275"],"link":[{"URL":"https://publications.aap.org/pediatrics/article-pdf/doi/10.1542/peds.2025-071147/1889916/pediatrics.2025071147.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https://publications.aap.org/pediatrics/article-pdf/doi/10.1542/peds.2025-071147/1889916/pediatrics.2025071147.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":"6","score":1,"title":["Buprenorphine Treatment Duration and Adherence Among Youth and Subsequent Health Outcomes"],"author":[{"given":"Scott E.","family":"Hadland","sequence":"first","affiliation":[{"name":"1Division of Adolescent and Young Adult Medicine, Mass General Brigham for Children, Boston, Massachusetts"},{"name":"2Harvard Medical School, Boston, Massachusetts"}]},{"given":"Simeon D.","family":"Kimmel","sequence":"additional","affiliation":[{"name":"3Boston Medical Center, Boston, Massachusetts"},{"name":"4Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts"}]},{"given":"Shapei","family":"Yan","sequence":"additional","affiliation":[{"name":"3Boston Medical Center, Boston, Massachusetts"},{"name":"4Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts"}]},{"given":"Amy L.","family":"Bettano","sequence":"additional","affiliation":[{"name":"5Department of Public Health, Commonwealth of Massachusetts, Boston, Massachusetts"}]},{"given":"Wei-Hsuan","family":"Lo-Ciganic","sequence":"additional","affiliation":[{"name":"6Division of General Internal Medicine, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania"},{"name":"7Center for Pharmaceutical Policy and Prescribing, University of Pittsburgh, Pittsburgh, Pennsylvania"},{"name":"8Center for Clinical Artificial Intelligence, University of Pittsburgh, Pittsburgh, Pennsylvania"},{"name":"9North Florida/South Georgia Veterans Health System Geriatric Research Education and Clinical Center, Gainesville, Florida"}]},{"given":"Sarah M.","family":"Bagley","sequence":"additional","affiliation":[{"name":"3Boston Medical Center, Boston, Massachusetts"},{"name":"4Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts"}]},{"given":"Jessica B.","family":"Calihan","sequence":"additional","affiliation":[{"name":"3Boston Medical Center, Boston, Massachusetts"},{"name":"4Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts"}]},{"given":"Heather E.","family":"Hsu","sequence":"additional","affiliation":[{"name":"3Boston Medical Center, Boston, Massachusetts"},{"name":"4Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts"}]},{"given":"Marc R.","family":"Larochelle","sequence":"additional","affiliation":[{"name":"3Boston Medical Center, Boston, Massachusetts"},{"name":"4Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts"}]}],"issued":{"date-parts":[[2025,11,18]]},"member":"417","prefix":"10.1542","source":"Crossref","volume":"156","created":{"date-time":"2025-11-18T00:02:42Z","timestamp":1763424162000,"date-parts":[[2025,11,18]]},"indexed":{"date-time":"2025-12-01T00:02:23Z","timestamp":1764547343900,"date-parts":[[2025,12,1]]},"subject":[],"abstract":"$35","language":"en","relation":{},"resource":{"primary":{"URL":"https://publications.aap.org/pediatrics/article/156/6/e2025071147/205461/Buprenorphine-Treatment-Duration-and-Adherence"}},"subtitle":[],"deposited":{"date-time":"2025-11-30T23:57:30Z","timestamp":1764547050000,"date-parts":[[2025,11,30]]},"issn-type":[{"type":"print","value":"0031-4005"},{"type":"electronic","value":"1098-4275"}],"published":{"date-parts":[[2025,11,18]]},"publisher":"American Academy of Pediatrics (AAP)","reference":[{"DOI":null,"key":"2025113018572172900_r1","year":"2024","issue":null,"author":"Substance Abuse and Mental Health Services 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were not reported in the excerpt beyond directional statements.","value_numeric":null},{"paper_doi":"10.1542/peds.2025-071147","tag_type":"warning","value":"Study design classification is based on the provided abstract and methods summary.","value_numeric":null}],"summaries":{"what_studied":"A retrospective cohort of Massachusetts youth aged 13–26 initiating buprenorphine (2014–2022) grouped 12‑month duration/adherence trajectories and examined associations with overdose, emergency department (ED) use, and hospitalization in the following 12 months.","key_result":"Among 11,649 youth, four patterns emerged: high adherence 12 months (23.7%), low adherence 12 months (27.5%), discontinuation 3–9 months (16.4%), and discontinuation <3 months (32.5%); versus high adherence, overdose risk was higher with low adherence (aHR 1.46; 95% CI 1.24–1.73), discontinuation 3–9 months (1.82; 1.52–2.17), and <3 months (1.76; 1.50–2.06). Low adherence and <3‑month discontinuation had higher ED use, and all other trajectories had higher hospitalization.","practice_takeaway":"For youth with OUD on buprenorphine, maintaining high adherence for 12 months was associated with lower overdose, ED use, and hospitalization than lower adherence or early discontinuation; support 12‑month adherence to reduce harm."}}],"initialOffset":10,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"generic","value":"buprenorphine"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Generics","href":"/hub/tag/generic"},{"name":"buprenorphine"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"generic","hub_tag_value":"buprenorphine"}}}]]

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