{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T14:20:12Z","timestamp":1789827612382,"version":"4.0.1"},"reference-count":52,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T00:00:00Z","timestamp":1767744000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>Clinicians have little guidance on the ideal length of time patients should remain on medication treatment for opioid use disorder (MOUD) before being able to safely discontinue MOUD. This study estimated how the risk of all\u2010cause mortality changes with the duration of MOUD, controlling for patient characteristics that change the risk profile independent of duration of therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting and participants<\/jats:title>\n                    <jats:p>Retrospective cohort study using electronic health record data from the US Veterans Healthcare Administration. Veterans initiating MOUD with buprenorphine, methadone or extended\u2010release naltrexone from October 2010 to September 2020. Our analytic sample included 19\u2009666 buprenorphine initiators, 8675 methadone initiators and 4007 extended\u2010release naltrexone initiators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurement<\/jats:title>\n                    <jats:p>Duration of MOUD was measured in days. Discontinuation was defined as a gap in any MOUD coverage exceeding 28\u2009days, regardless of MOUD type initiated. The primary outcome was all\u2010cause mortality. We estimated multistate survival models allowing for the modeling of multiple states (i.e. on and off MOUD, death) without having to consider censoring or competing events, while adjusting for sociodemographic, clinical, prescription and facility and provider characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>We observed approximately 226\u2009000 person\u2010years of time at risk for discontinuation or pre\u2010discontinuation death, during which we observed 26\u2009841 discontinuations (118.9 discontinuations per 1000 person\u2010years). We similarly observed a total of about 106\u2009000 person\u2010years of post\u2010discontinuation follow\u2010up, during which we observed 3251 deaths (3.1 deaths per 1000 person\u2010years). We found the largest marginal gain in probability of 6\u2010year survival from an additional year on MOUD appears to occur around 2\u00a0years, as compared to 6\u00a0months on MOUD. Statistically significant gains continued through approximately 4\u20135\u00a0years of MOUD retention relative to 6\u2010month MOUD retention. After 4\u20135\u00a0years, the marginal gain from one additional year of MOUD was not statistically significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among US veterans, the benefit of retention on medication treatment for opioid use disorder (MOUD) towards overall survival continues through at least 4\u00a0years of MOUD treatment. Quality metrics based on 6\u2010month MOUD retention may be insufficient.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.70211","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T05:01:11Z","timestamp":1767848471000},"page":"922-933","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Evaluating the optimal duration of medication treatment for opioid use disorder"],"prefix":"10.1111","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7776-6157","authenticated-orcid":false,"given":"Corey J.","family":"Hayes","sequence":"first","affiliation":[{"name":"Division of Pharmaceutical Evaluation and Policy, College of Pharmacy University of Arkansas for Medical Sciences  Little Rock AR USA"},{"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":[{"vocabulary":"crossref","role":"author"}]},{"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":[{"vocabulary":"crossref","role":"author"}]},{"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":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nahiyan Bin","family":"Noor","sequence":"additional","affiliation":[{"name":"Institute for Digital Health and Innovation, College of Medicine University of Arkansas for Medical Sciences  Little Rock AR USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2055-3425","authenticated-orcid":false,"given":"Edward V.","family":"Nunes","sequence":"additional","affiliation":[{"name":"Division on Substance Use Disorders, Department of Psychiatry Columbia University Irving Medical Center  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3364-0739","authenticated-orcid":false,"given":"T. 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