{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T17:13:28Z","timestamp":1788542008592,"version":"build-2803163510"},"reference-count":28,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T00:00:00Z","timestamp":1622505600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R36HS027935"],"award-info":[{"award-number":["R36HS027935"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["T32HS026128"],"award-info":[{"award-number":["T32HS026128"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R37DA015612"],"award-info":[{"award-number":["R37DA015612"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aims<\/jats:title><jats:p>While long\u2010term medication\u2010assisted treatment (MAT) using methadone or buprenorphine is associated with significantly lower all\u2010cause mortality for individuals with opioid use disorder (OUD), periods of initiating or discontinuing treatment are associated with higher mortality risks relative to stable treatment. This study aimed to identify the OUD treatment durations necessary for the elevated mortality risks during treatment transitions to be balanced by reductions in mortality while receiving treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Simulation model based on a compartmental model of OUD diagnosis, MAT receipt and all\u2010cause mortality among Veterans with OUD in the United States Veterans Health Administration (VA) in 2017\u20132018. We simulated methadone and buprenorphine treatments of varying durations using parameters obtained through calibration and published meta\u2010analyses of studies from North America, Europe and Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Simulated cohorts of 10\u2009000 individuals with OUD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>All\u2010cause mortality over 12\u00a0months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Receiving methadone for 4\u00a0months or longer or buprenorphine for 2\u00a0months or longer resulted in 54 [95% confidence interval (CI)\u00a0=\u00a05\u201390] and 65 (95% CI\u00a0=\u00a021\u201389) fewer deaths relative to not receiving MAT for the same duration, using VA\u2010specific mortality rates. We estimated shorter treatment durations necessary to achieve net mortality benefits of 2\u00a0months or longer for methadone and 1\u00a0month or longer for buprenorphine, using non\u2010VA population literature estimates. Sensitivity analyses demonstrated that necessary treatment durations increased more with smaller mortality reductions on treatment than with larger relative risks during treatment transitions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Short periods (&lt;\u00a06\u00a0months) of treatment with either methadone or buprenorphine are likely to yield net mortality benefits for people with opioid use disorder relative to receiving no medications, despite periods of elevated all\u2010cause mortality risk during transitions into and out of treatment. Retaining people with opioid use disorder in treatment longer can increase these benefits.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.15574","type":"journal-article","created":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T12:44:18Z","timestamp":1621255458000},"page":"3494-3503","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Impact of treatment duration on mortality among Veterans with opioid use disorder in the United States Veterans Health Administration"],"prefix":"10.1111","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0752-8628","authenticated-orcid":false,"given":"Jack H.","family":"Ching","sequence":"first","affiliation":[{"name":"Center for Health Policy and Center for Primary Care and Outcomes Research Stanford University School of Medicine  Stanford CA USA"},{"name":"Program Evaluation and Resource Center Office of Mental Health and Suicide Prevention, VA Palo Alto Health Care System  Menlo Park CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas K.","family":"Owens","sequence":"additional","affiliation":[{"name":"Center for Health Policy and Center for Primary Care and Outcomes Research Stanford University School of Medicine  Stanford CA USA"},{"name":"VA Palo Alto Health Care System  Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jodie A.","family":"Trafton","sequence":"additional","affiliation":[{"name":"Program Evaluation and Resource Center Office of Mental Health and Suicide Prevention, VA Palo Alto Health Care System  Menlo Park CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy D.","family":"Goldhaber\u2010Fiebert","sequence":"additional","affiliation":[{"name":"Center for Health Policy and Center for Primary Care and Outcomes Research Stanford University School of Medicine  Stanford CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3929-5515","authenticated-orcid":false,"given":"Joshua A.","family":"Salomon","sequence":"additional","affiliation":[{"name":"Center for Health Policy and Center for Primary Care and Outcomes Research Stanford University School of Medicine  Stanford CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(18)30337-7"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596.dsm16"},{"key":"e_1_2_8_4_1","volume-title":"Medications for Opioid Use Disorder Save Lives","author":"National Academies of Sciences Engineering and Medicine","year":"2019"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000166"},{"key":"e_1_2_8_6_1","unstructured":"Department of Veterans Affairs (VA) Department of Defense (DoD).VA\/DoD Clinical Practice Guideline for the Management of Substance Use Disorders. Washington DC: VA\/DoD;2015 1\u2013169."},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.15087"},{"key":"e_1_2_8_8_1","unstructured":"Center for Behavioral Health Statistics and Quality.2017 National Survey on Drug Use and Health: Detailed Tables. Rockville MD: Substance Abuse and Mental Health Services Administration;2018."},{"key":"e_1_2_8_9_1","first-page":"1","article-title":"Drug overdose deaths in the United States, 1999\u20132017","volume":"329","author":"Hedegaard H.","year":"2018","journal-title":"NCHS Data Brief"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2018.1452327"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/10550887.2016.1100960"},{"key":"e_1_2_8_12_1","first-page":"1","article-title":"Retention of patients in opioid substitution treatment: a systematic review","volume":"15","author":"O'Connor A. M.","year":"2020","journal-title":"PLOS ONE"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.5455\/medarh.2013.67.48-50"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/14656566.2016.1232391"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1086\/338011"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2014.01.495"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2009.05.021"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j1550"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2011.05.001"},{"key":"e_1_2_8_20_1","first-page":"S56","article-title":"Effects of medication\u2010assisted treatment on mortality among opioids users: a systematic review and meta\u2010analysis","volume":"390","author":"Ma J.","year":"2018","journal-title":"Mol Psychiatry"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2018.304590"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.7621"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/00952990.2018.1546862"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2012.03870.x"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2011.121"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2015.12.035"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1541-0420.2010.01399.x"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(15)00366-1"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j1947"}],"container-title":["Addiction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.15574","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/add.15574","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.15574","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T13:20:05Z","timestamp":1693228805000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/add.15574"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6]]},"references-count":28,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1111\/add.15574"],"URL":"https:\/\/doi.org\/10.1111\/add.15574","archive":["Portico"],"relation":{},"ISSN":["0965-2140","1360-0443"],"issn-type":[{"value":"0965-2140","type":"print"},{"value":"1360-0443","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6]]},"assertion":[{"value":"2020-12-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}