Risk of acute care incidents for people treated for opioid use disorder with extended-release naltrexone and buprenorphine

Abstract

ABSTRACT Buprenorphine treatment has an established history of reducing opioid overdoses; however, extended-release naltrexone does not have the same track record. This study evaluates the risk of patients with opioid use disorder experiencing an acute-care incident treated with extended-release naltrexone compared to those treated with buprenorphine. A generalized estimating equation was used to estimate the association of days in treatment with extended-release naltrexone or buprenorphine with the need for emergency room or inpatient acute care in a sample of 29,727 people with private insurance in the United States. The study found that for every day in treatment with either medication there was a 10% reduction in the odds of experiencing an acute-care incident during the course of a month. The apparent parity of extended-release naltrexone and buprenorphine in reducing overdose and other acute-care incidents emphasizes the need for prescribers to make all medications for opioid use disorder available to treatment seekers.