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: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.31: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. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"methadone: generic Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on methadone (generic). Clinician-written summaries and actionable practice insights. 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Small number of dams (n=26) limits statistical power. Mechanisms mediating NaB rescue were not fully characterized beyond the microbiota-gut-brain axis.","practice_takeaway":"While not yet ready for clinical use, these findings position maternal or perinatal sodium butyrate supplementation as a candidate intervention worth evaluating in human trials for prenatal opioid-exposed infants. Clinicians managing neonatal opioid withdrawal syndrome (NOWS) should watch for emerging translational data on gut-brain axis therapies."}},{"doi":"10.1001/jamapsychiatry.2026.2506","pmid":"42616551","title":"Racial and Ethnic Disparities in Treatment Discontinuation in Pregnant Females With Opioid Use Disorder","journal_title":"JAMA Psychiatry","journal_issn":"2168-622X","published_at":"2026-08-19T00:00:00.000Z","url":"https://doi.org/10.1001/jamapsychiatry.2026.2506","source_score":24,"is_retracted":false,"is_open_access":null,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":false},"created_at":"2026-08-20T06:47:52.170Z","updated_at":"2026-08-20T06:47:52.170Z","tags":[{"paper_doi":"10.1001/jamapsychiatry.2026.2506","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.2506","tag_type":"category","value":"Psychiatry","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.2506","tag_type":"condition","value":"Opioid Use Disorder","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.2506","tag_type":"generic","value":"buprenorphine","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.2506","tag_type":"generic","value":"methadone","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.2506","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.2506","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.2506","tag_type":"modality","value":"Opioid Agonist Therapy","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.2506","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.2506","tag_type":"study_design","value":"Cohort Study","value_numeric":null},{"paper_doi":"10.1001/jamapsychiatry.2026.2506","tag_type":"warning","value":"Only the abstract is available; 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. 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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."}}],"initialOffset":6,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"generic","value":"methadone"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Generics","href":"/hub/tag/generic"},{"name":"methadone"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"generic","hub_tag_value":"methadone"}}}]]

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