{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"submitter":["Morgan JR"],"funding":["NCIPC CDC HHS","NIDA NIH HHS","ACL HHS","NIAID NIH HHS","National Center for Injury Prevention and Control","National Institutes of Health","National Institute on Drug Abuse"],"pagination":["108764"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC8488795"],"repository":["biostudies-literature"],"omics_type":["Unknown"],"volume":["225"],"pubmed_abstract":["<h4>Background and aims</h4>While the United States is in the midst of an overdose epidemic, effective treatments are underutilized and commonly discontinued. Innovations in medication delivery, including an extended-release formulations, have the potential to improve treatment access and reduce discontinuation. We sought to assess extended-release buprenorphine discontinuation among individuals with opioid use disorder (OUD) in a real-world, nationally representative cohort.<h4>Setting</h4>United States PARTICIPANTS: Commercially insured individuals initiating one of four FDA-approved medications for opioid use disorder (MOUD) in 2018: extended-release buprenorphine, extended-release naltrexone, mucosal buprenorphine (mono- or co-formulated with naloxone), or methadone.<h4>Measurements</h4>Our primary outcome was medication discontinuation, defined as a gap of more than 14 days between the end of one prescription or administration and the subsequent dose.<h4>Findings</h4>We identified 14,358 individuals initiating MOUD in 2018, including 204 (1%) extended-release buprenorphine, 1,173 (8%) extended-release naltrexone, 12,171 (85%) mucosal buprenorphine, and 810 (6%) methadone initiations. Three months after initiation, 50% (95% confidence interval [CI] 40%-60%) of extended-release buprenorphine, 64% (95% CI 61%-69%) of extended-release naltrexone, 34% (95% CI 33%-35%) of mucosal buprenorphine, and 58% (95% CI 54%-62%) of methadone initiators had discontinued treatment.<h4>Conclusions</h4>Across all treatment groups, medication discontinuation was high, and in this sample of early adopters with limited follow-up time, we found no evidence that extended-release buprenorphine offered a retention advantage compared to other MOUD in real-world settings. Retention continues to represent a major obstacle to treatment effectiveness, and interventions are needed to address this challenge even as new MOUD formulations become available."],"journal":["Drug and alcohol dependence"],"pubmed_title":["Characterizing initiation, use, and discontinuation of extended-release buprenorphine in a nationally representative United States commercially insured cohort."],"pmcid":["PMC8488795"],"funding_grant_id":["R01 CE002999","P30 AI042853","K23 DA044085","R01 DA046527","K23DA044085","P30DA040500","R01CE002999","P30 DA040500","R01046527"],"pubmed_authors":["Hadland SE","Linas BP","Barocas J","Murphy SM","Assoumou SA","Chatterjee A","Walley AY","Morgan JR"],"additional_accession":[]},"is_claimable":false,"name":"Characterizing initiation, use, and discontinuation of extended-release buprenorphine in a nationally representative United States commercially insured cohort.","description":"<h4>Background and aims</h4>While the United States is in the midst of an overdose epidemic, effective treatments are underutilized and commonly discontinued. Innovations in medication delivery, including an extended-release formulations, have the potential to improve treatment access and reduce discontinuation. We sought to assess extended-release buprenorphine discontinuation among individuals with opioid use disorder (OUD) in a real-world, nationally representative cohort.<h4>Setting</h4>United States PARTICIPANTS: Commercially insured individuals initiating one of four FDA-approved medications for opioid use disorder (MOUD) in 2018: extended-release buprenorphine, extended-release naltrexone, mucosal buprenorphine (mono- or co-formulated with naloxone), or methadone.<h4>Measurements</h4>Our primary outcome was medication discontinuation, defined as a gap of more than 14 days between the end of one prescription or administration and the subsequent dose.<h4>Findings</h4>We identified 14,358 individuals initiating MOUD in 2018, including 204 (1%) extended-release buprenorphine, 1,173 (8%) extended-release naltrexone, 12,171 (85%) mucosal buprenorphine, and 810 (6%) methadone initiations. Three months after initiation, 50% (95% confidence interval [CI] 40%-60%) of extended-release buprenorphine, 64% (95% CI 61%-69%) of extended-release naltrexone, 34% (95% CI 33%-35%) of mucosal buprenorphine, and 58% (95% CI 54%-62%) of methadone initiators had discontinued treatment.<h4>Conclusions</h4>Across all treatment groups, medication discontinuation was high, and in this sample of early adopters with limited follow-up time, we found no evidence that extended-release buprenorphine offered a retention advantage compared to other MOUD in real-world settings. Retention continues to represent a major obstacle to treatment effectiveness, and interventions are needed to address this challenge even as new MOUD formulations become available.","dates":{"release":"2021-01-01T00:00:00Z","publication":"2021 Aug","modification":"2025-04-26T16:36:05.023Z","creation":"2025-04-06T15:13:11.379Z"},"accession":"S-EPMC8488795","cross_references":{"pubmed":["34051547"],"doi":["10.1016/j.drugalcdep.2021.108764"]}}