MAT with Buprenorphine, Methadone Superior to Other OUD Treatments in Preventing Overdoses

Medication-assisted treatment (MAT) with buprenorphine or methadone is the gold standard for treating individuals with opioid use disorder (OUD), a new study suggests.

Compared to other methods of treatment, researchers discovered that when buprenorphine or methadone are administered to individuals with OUD as part of their MAT regimen, they are less likely to experience an overdose or other health crisis months later.

The study was published in JAMA Network Open, and researchers claim the findings could make more of a case for OUD services to be covered by insurance.

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For the study, they looked at the health and treatment outcomes of nearly 41,000 individuals ages 16 and older from across the country, representing various races and ethnicities.

Information on the patients was obtained from a database compiled by health care data provider Optum Labs, a subsidiary of the insurer UnitedHealth Group (NYSE:UNH).

The individuals analyzed either had commercial insurance plans or Medicare Advantage between October 2014 and December 2017.

Medicare Advantage provides regular Medicare benefits through private insurance plans and is open to anyone under the age of 65 with a disability, in addition to those 65 and older who qualify for regular Medicaid.

Researchers compared the efficacy of buprenorphine and methadone MAT to five other treatment methods.

Those included inpatient detoxification or residential services, intensive outpatient services or partial hospitalization, outpatient counseling, MAT with the opioid relapse prevention drug naltrexone and no treatment.

The progress of individuals was subsequently analyzed three and 12 months after initially seeking treatment. Researchers discovered that despite MAT with buprenorphine and methadone not being the most frequently used treatment method (outpatient counseling was the most common), the drugs were linked less to patients overdosing or experiencing other opioid-related emergencies that necessitated immediate care.

MAT with buprenorphine or methadone was associated with individuals being 76% less likely to have an overdose three months after beginning treatment, and 59% less likely 12 months afterward.

The use of buprenorphine or methadone as a treatment pathway also resulted in individuals being 32% less likely to experience other serious opioid-related health incidents requiring immediate care three months after treatment began.

Additionally, 12 months after the initiation of buprenorphine or methadone, individuals were 26% less likely to experience such an episode.

By contrast, detox and residential assistance, intensive behavioral health services and the administration of naltrexone did not reduce the risks of overdoses or other serious opioid-related health incidents after several months.

The study’s authors said their findings mirrored those of other previously published studies linking MAT with buprenorphine or methadone to better patient outcomes, which include lower opioid mortality rates and medical costs.

They also specifically noted that insurers could look at the findings as a rationale for why MAT services should be covered in their health plans.

“These findings suggest that opportunities exist for health plans to reduce restrictions on use for MOUD [medication for opioid use disorder] and the need for treatment models that prioritize access to and retention of MOUD treatment,” the authors stated at the study’s conclusion.

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