Association of buprenorphine retention and subsequent adverse outcomes following non-fatal overdose: An analysis using statewide linked Maryland databases
Patients receiving buprenorphine after a non-fatal overdose have lower risk of future nonfatal or fatal overdose, but less is known about the relationship between buprenorphine retention and the risk of adverse outcomes in the post-overdose year. To examine the relationship between the total number...
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| Veröffentlicht in: | Drug and alcohol dependence 2024-05, Vol.258, p.111281-111281, Article 111281 |
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| creator | Sugarman, Olivia K. Saloner, Brendan Richards, Thomas M. Lasser, Elyse C. Heath, Teresa Idries, Shima Weiner, Jonathan P. Bandara, Sachini |
| description | Patients receiving buprenorphine after a non-fatal overdose have lower risk of future nonfatal or fatal overdose, but less is known about the relationship between buprenorphine retention and the risk of adverse outcomes in the post-overdose year.
To examine the relationship between the total number of months with an active buprenorphine prescription (retention) and the odds of an adverse outcome within the 12 months following an index non-fatal overdose.
We studied a cohort of people with an index non-fatal opioid overdose in Maryland between July 2016 and December 2020 and at least one filled buprenorphine prescription in the 12-month post-overdose observation period. We used individually linked Maryland prescription drug and hospital admissions data. Multivariable logistic regression models were used to examine buprenorphine retention and associated odds of experiencing a second non-fatal overdose, all-cause emergency department visits, and all-cause hospitalizations.
Of 5439 people, 25% (n=1360) experienced a second non-fatal overdose, 78% had an (n=4225) emergency department visit, and 37% (n=2032) were hospitalized. With each additional month of buprenorphine, the odds of experiencing another non-fatal overdose decreased by 4.7%, all-cause emergency department visits by 5.3%, and all-cause hospitalization decreased by 3.9% (p |
| doi_str_mv | 10.1016/j.drugalcdep.2024.111281 |
| format | Article |
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To examine the relationship between the total number of months with an active buprenorphine prescription (retention) and the odds of an adverse outcome within the 12 months following an index non-fatal overdose.
We studied a cohort of people with an index non-fatal opioid overdose in Maryland between July 2016 and December 2020 and at least one filled buprenorphine prescription in the 12-month post-overdose observation period. We used individually linked Maryland prescription drug and hospital admissions data. Multivariable logistic regression models were used to examine buprenorphine retention and associated odds of experiencing a second non-fatal overdose, all-cause emergency department visits, and all-cause hospitalizations.
Of 5439 people, 25% (n=1360) experienced a second non-fatal overdose, 78% had an (n=4225) emergency department visit, and 37% (n=2032) were hospitalized. With each additional month of buprenorphine, the odds of experiencing another non-fatal overdose decreased by 4.7%, all-cause emergency department visits by 5.3%, and all-cause hospitalization decreased by 3.9% (p<.0001, respectively). Buprenorphine retention for at least nine months was a critical threshold for reducing overdose risk versus shorter buprenorphine retention.
Buprenorphine retention following an index non-fatal overdose event significantly decreases the risk of future overdose, emergency department use, and hospitalization even among people already on buprenorphine.
•Little is known about buprenorphine use and outcomes after non-fatal overdose.•We analyzed the relationship between buprenorphine retention and adverse outcomes after an overdose.•61% (n=3232) of subjects had an active buprenorphine prescription for ≥ 6 months.•Risk of adverse outcomes decreased 4%-5% with each month of buprenorphine.•Buprenorphine for ≥9 months appeared to be the threshold to reduce adverse outcomes.</description><identifier>ISSN: 0376-8716</identifier><identifier>EISSN: 1879-0046</identifier><identifier>DOI: 10.1016/j.drugalcdep.2024.111281</identifier><identifier>PMID: 38599134</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Buprenorphine ; Buprenorphine retention ; Hospitalization ; Maryland ; Medications for opioid use disorder ; Overdose</subject><ispartof>Drug and alcohol dependence, 2024-05, Vol.258, p.111281-111281, Article 111281</ispartof><rights>2024 Elsevier B.V.</rights><rights>Copyright © 2024 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c319t-f395a7da9e2f6088a98e0f97cad92f2fe2e0e737cb576a4448ec1b01ab7907063</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0376871624002023$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38599134$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sugarman, Olivia K.</creatorcontrib><creatorcontrib>Saloner, Brendan</creatorcontrib><creatorcontrib>Richards, Thomas M.</creatorcontrib><creatorcontrib>Lasser, Elyse C.</creatorcontrib><creatorcontrib>Heath, Teresa</creatorcontrib><creatorcontrib>Idries, Shima</creatorcontrib><creatorcontrib>Weiner, Jonathan P.</creatorcontrib><creatorcontrib>Bandara, Sachini</creatorcontrib><title>Association of buprenorphine retention and subsequent adverse outcomes following non-fatal overdose: An analysis using statewide linked Maryland databases</title><title>Drug and alcohol dependence</title><addtitle>Drug Alcohol Depend</addtitle><description>Patients receiving buprenorphine after a non-fatal overdose have lower risk of future nonfatal or fatal overdose, but less is known about the relationship between buprenorphine retention and the risk of adverse outcomes in the post-overdose year.
To examine the relationship between the total number of months with an active buprenorphine prescription (retention) and the odds of an adverse outcome within the 12 months following an index non-fatal overdose.
We studied a cohort of people with an index non-fatal opioid overdose in Maryland between July 2016 and December 2020 and at least one filled buprenorphine prescription in the 12-month post-overdose observation period. We used individually linked Maryland prescription drug and hospital admissions data. Multivariable logistic regression models were used to examine buprenorphine retention and associated odds of experiencing a second non-fatal overdose, all-cause emergency department visits, and all-cause hospitalizations.
Of 5439 people, 25% (n=1360) experienced a second non-fatal overdose, 78% had an (n=4225) emergency department visit, and 37% (n=2032) were hospitalized. With each additional month of buprenorphine, the odds of experiencing another non-fatal overdose decreased by 4.7%, all-cause emergency department visits by 5.3%, and all-cause hospitalization decreased by 3.9% (p<.0001, respectively). Buprenorphine retention for at least nine months was a critical threshold for reducing overdose risk versus shorter buprenorphine retention.
Buprenorphine retention following an index non-fatal overdose event significantly decreases the risk of future overdose, emergency department use, and hospitalization even among people already on buprenorphine.
•Little is known about buprenorphine use and outcomes after non-fatal overdose.•We analyzed the relationship between buprenorphine retention and adverse outcomes after an overdose.•61% (n=3232) of subjects had an active buprenorphine prescription for ≥ 6 months.•Risk of adverse outcomes decreased 4%-5% with each month of buprenorphine.•Buprenorphine for ≥9 months appeared to be the threshold to reduce adverse outcomes.</description><subject>Buprenorphine</subject><subject>Buprenorphine retention</subject><subject>Hospitalization</subject><subject>Maryland</subject><subject>Medications for opioid use disorder</subject><subject>Overdose</subject><issn>0376-8716</issn><issn>1879-0046</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNqFkc1u1DAUhS0EotPCKyAv2WRqJxn_sBuq8iMVsYG15djXxUPGDr5Jq74KT4vDFFjijSXf79xzrw8hlLMtZ1xcHra-LLd2dB6mbcvafss5bxV_QjZcSd0w1ounZMM6KRoluTgj54gHVo_Q7Dk569ROa971G_Jzj5hdtHPMieZAh2UqkHKZvsUEtMAM6XfJJk9xGRB-LPWFWn8HBYHmZXb5CEhDHsd8H9MtTTk1wc52pLkyPiO8ofu1gR0fMCJdcKVwtjPcRw90jOk7ePrJlodxdfFVO1gEfEGeBTsivHy8L8jXd9dfrj40N5_ff7za3zSu43puQqd3VnqroQ2CKWW1Aha0dNbrNrQBWmAgO-mGnRS273sFjg-M20FqJpnoLsjrU9-p5LodzuYY0cFYp4G8oOnqN3ZaCdFXVJ1QVzJigWCmEo91csOZWZMxB_MvGbMmY07JVOmrR5dlOIL_K_wTRQXengCou95FKAZdhOTAxwJuNj7H_7v8AqU2qWE</recordid><startdate>20240501</startdate><enddate>20240501</enddate><creator>Sugarman, Olivia K.</creator><creator>Saloner, Brendan</creator><creator>Richards, Thomas M.</creator><creator>Lasser, Elyse C.</creator><creator>Heath, Teresa</creator><creator>Idries, Shima</creator><creator>Weiner, Jonathan P.</creator><creator>Bandara, Sachini</creator><general>Elsevier B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20240501</creationdate><title>Association of buprenorphine retention and subsequent adverse outcomes following non-fatal overdose: An analysis using statewide linked Maryland databases</title><author>Sugarman, Olivia K. ; Saloner, Brendan ; Richards, Thomas M. ; Lasser, Elyse C. ; Heath, Teresa ; Idries, Shima ; Weiner, Jonathan P. ; Bandara, Sachini</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c319t-f395a7da9e2f6088a98e0f97cad92f2fe2e0e737cb576a4448ec1b01ab7907063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Buprenorphine</topic><topic>Buprenorphine retention</topic><topic>Hospitalization</topic><topic>Maryland</topic><topic>Medications for opioid use disorder</topic><topic>Overdose</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sugarman, Olivia K.</creatorcontrib><creatorcontrib>Saloner, Brendan</creatorcontrib><creatorcontrib>Richards, Thomas M.</creatorcontrib><creatorcontrib>Lasser, Elyse C.</creatorcontrib><creatorcontrib>Heath, Teresa</creatorcontrib><creatorcontrib>Idries, Shima</creatorcontrib><creatorcontrib>Weiner, Jonathan P.</creatorcontrib><creatorcontrib>Bandara, Sachini</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Drug and alcohol dependence</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sugarman, Olivia K.</au><au>Saloner, Brendan</au><au>Richards, Thomas M.</au><au>Lasser, Elyse C.</au><au>Heath, Teresa</au><au>Idries, Shima</au><au>Weiner, Jonathan P.</au><au>Bandara, Sachini</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of buprenorphine retention and subsequent adverse outcomes following non-fatal overdose: An analysis using statewide linked Maryland databases</atitle><jtitle>Drug and alcohol dependence</jtitle><addtitle>Drug Alcohol Depend</addtitle><date>2024-05-01</date><risdate>2024</risdate><volume>258</volume><spage>111281</spage><epage>111281</epage><pages>111281-111281</pages><artnum>111281</artnum><issn>0376-8716</issn><eissn>1879-0046</eissn><abstract>Patients receiving buprenorphine after a non-fatal overdose have lower risk of future nonfatal or fatal overdose, but less is known about the relationship between buprenorphine retention and the risk of adverse outcomes in the post-overdose year.
To examine the relationship between the total number of months with an active buprenorphine prescription (retention) and the odds of an adverse outcome within the 12 months following an index non-fatal overdose.
We studied a cohort of people with an index non-fatal opioid overdose in Maryland between July 2016 and December 2020 and at least one filled buprenorphine prescription in the 12-month post-overdose observation period. We used individually linked Maryland prescription drug and hospital admissions data. Multivariable logistic regression models were used to examine buprenorphine retention and associated odds of experiencing a second non-fatal overdose, all-cause emergency department visits, and all-cause hospitalizations.
Of 5439 people, 25% (n=1360) experienced a second non-fatal overdose, 78% had an (n=4225) emergency department visit, and 37% (n=2032) were hospitalized. With each additional month of buprenorphine, the odds of experiencing another non-fatal overdose decreased by 4.7%, all-cause emergency department visits by 5.3%, and all-cause hospitalization decreased by 3.9% (p<.0001, respectively). Buprenorphine retention for at least nine months was a critical threshold for reducing overdose risk versus shorter buprenorphine retention.
Buprenorphine retention following an index non-fatal overdose event significantly decreases the risk of future overdose, emergency department use, and hospitalization even among people already on buprenorphine.
•Little is known about buprenorphine use and outcomes after non-fatal overdose.•We analyzed the relationship between buprenorphine retention and adverse outcomes after an overdose.•61% (n=3232) of subjects had an active buprenorphine prescription for ≥ 6 months.•Risk of adverse outcomes decreased 4%-5% with each month of buprenorphine.•Buprenorphine for ≥9 months appeared to be the threshold to reduce adverse outcomes.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>38599134</pmid><doi>10.1016/j.drugalcdep.2024.111281</doi><tpages>1</tpages></addata></record> |
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| subjects | Buprenorphine Buprenorphine retention Hospitalization Maryland Medications for opioid use disorder Overdose |
| title | Association of buprenorphine retention and subsequent adverse outcomes following non-fatal overdose: An analysis using statewide linked Maryland databases |
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