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Participants were veterans initiating MOUD with buprenorphine (BUP), methadone (MET) or extended\u2010release naltrexone (XR\u2010NTX) from fiscal years 2012\u201319. A total of 39\u2009284 veterans met eligibility with 22\u2009721 (57.8%) initiating BUP, 12\u2009652 (32.2%) initiating MET and 3911 (10.0%) initiating XR\u2010NTX.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Measurements (1) determined whether the veteran experienced an overdose in the 365\u2009days after MOUD initiation (primary) and (2) early discontinuation of MOUD, defined as discontinuation before 180\u2009days (secondary). We assumed that unobserved patient characteristics would jointly influence the probability of discontinuation and overdose. and estimated the joint distribution with a bivariate probit model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>We found that 9.0% of BUP initiators who experienced an overdose above the predicted 3.9% had no veteran\u2010discontinued BUP early; findings for XR\u2010NTX were similar, with 12.2% of initiators overdosing above the predicted 4.5%, but this was statistically inconclusive. We found no relationship between early discontinuation and overdose for MET initiators, probably due to the high risk of both events. The patient characteristics included in our post\u2010estimation exploratory analysis of early discontinuation varied by MOUD type, with between 14 (XR\u2010NTX) and 25 (BUP) tested. The only characteristics with at least one level showing a statistically significant change in probability of early discontinuation for all three MOUD types were geography and prior\u2010year exposure to psychotherapy, although direction and magnitude varied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early discontinuation of buprenorphine, and probably extended\u2010release naltrexone, appears to be associated with a greater probability of experiencing a fatal or non\u2010fatal overdose among US veterans receiving medication for opioid use disorder (MOUD); methadone does not show the same association. There is no consistent set of characteristics among early discontinuers by MOUD type.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.16659","type":"journal-article","created":{"date-parts":[[2024,9,7]],"date-time":"2024-09-07T06:29:41Z","timestamp":1725690581000},"page":"138-151","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Medications for opioid use disorder: Predictors of early discontinuation and reduction of overdose risk in US military veterans by medication type"],"prefix":"10.1111","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7776-6157","authenticated-orcid":false,"given":"Corey J.","family":"Hayes","sequence":"first","affiliation":[{"name":"Department of Biomedical Informatics, College of Medicine University of Arkansas for Medical Sciences  Little Rock AR USA"},{"name":"Institute for Digital Health and Innovation, College of Medicine University of Arkansas for Medical Sciences  Little Rock AR USA"},{"name":"Center for Mental Healthcare and Outcomes Research Central Arkansas Veterans Healthcare System  North Little Rock AR USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4135-9074","authenticated-orcid":false,"given":"Rebecca A.","family":"Raciborski","sequence":"additional","affiliation":[{"name":"Center for Mental Healthcare and Outcomes Research Central Arkansas Veterans Healthcare System  North Little Rock AR USA"},{"name":"Behavioral Health Quality Enhancement Research Initiative Central Arkansas Veterans Healthcare System  North Little Rock AR USA"},{"name":"Evidence, Policy, and Implementation Center Central Arkansas Veterans Healthcare System  North Little Rock AR USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Nowak","sequence":"additional","affiliation":[{"name":"College of Medicine University of Arkansas for Medical Sciences  Little Rock AR USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahip","family":"Acharya","sequence":"additional","affiliation":[{"name":"Institute for Digital Health and Innovation, College of Medicine University of Arkansas for Medical Sciences  Little Rock AR USA"},{"name":"Department of Obstetrics and Gynecology, College of Medicine University of Arkansas for Medical Sciences  Little Rock AR USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2055-3425","authenticated-orcid":false,"suffix":"Jr","given":"Edward V.","family":"Nunes","sequence":"additional","affiliation":[{"name":"Division of Substance Use Disorders, Department of Psychiatry Columbia University Irving Medical Center  New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3364-0739","authenticated-orcid":false,"given":"T. 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