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The objective of this study was to investigate the relative effectiveness of buprenorphine\/naloxone and methadone on retention and suppression of opioid use among individuals with opioid use disorder (OUD) and history of NFO.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Secondary analysis of a pan\u2010Canadian pragmatic trial comparing flexible take\u2010home buprenorphine\/naloxone and supervised methadone for people with OUD and history of NFO. Logistic regression was used to examine the impact of OAT on retention in the assigned or in any OAT at 24 weeks and analysis of covariance was used to examine the mean difference in opioid use between treatment arms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 272 randomized participants, 155 (57%) reported at least one NFO at baseline. Retention rates in the assigned treatment were 17.7% in the buprenorphine\/naloxone group and 18.4% in the methadone group (adjusted odds ratio [AOR]\u2009=\u20090.54, 95% CI: 0.17\u20131.54). Rates of retention in any OAT were 28% and 20% in the buprenorphine\/naloxone and methadone arms, respectively (AOR\u2009=\u20091.55, 95% CI: 0.65\u20133.78). There was an 11.9% adjusted mean difference in opioid\u2010free urine drug tests, favoring the buprenorphine\/naloxone arm (95% CI: 3.5\u201320.3; <jats:italic>p<\/jats:italic>\u2009=\u2009.0057).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Scientific Significance<\/jats:title><jats:p>Among adults with OUD and a history of overdose, overall retention rates were low but improved when retention in any treatment was considered. These findings highlight the importance of flexibility and patient\u2010centered care to improve retention and other treatment outcomes in this population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajad.13635","type":"journal-article","created":{"date-parts":[[2024,8,11]],"date-time":"2024-08-11T06:28:40Z","timestamp":1723357720000},"page":"50-59","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Opioid agonist treatment outcomes among individuals with a history of nonfatal overdose: Findings from a pragmatic, pan\u2010Canadian, randomized control trial"],"prefix":"10.1111","volume":"34","author":[{"given":"Hannah","family":"Crepeault","sequence":"first","affiliation":[{"name":"British Columbia Centre on Substance Use Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lianping","family":"Ti","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use Vancouver British Columbia Canada"},{"name":"Department of Medicine, Faculty of Medicine University of British Columbia Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2413-9133","authenticated-orcid":false,"given":"Paxton","family":"Bach","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use Vancouver British Columbia Canada"},{"name":"Department of Medicine, Faculty of Medicine University of British Columbia Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evan","family":"Wood","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use Vancouver British Columbia Canada"},{"name":"Department of Medicine, Faculty of Medicine University of British Columbia Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8474-508X","authenticated-orcid":false,"given":"Didier","family":"Jutras\u2010Aswad","sequence":"additional","affiliation":[{"name":"Research Centre Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al (CRCHUM) Montr\u00e9al Quebec Canada"},{"name":"Department of Psychiatry and Addictology, Faculty of Medicine Universit\u00e9 de Montr\u00e9al Montr\u00e9al Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard","family":"Le Foll","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Toxicology, Faculty of Medicine, Medical Sciences Building University of Toronto Toronto Ontario Canada"},{"name":"Department of Family and Community Medicine, Faculty of Medicine University of Toronto Toronto Ontario Canada"},{"name":"Department of Psychiatry University of Toronto Toronto Ontario Canada"},{"name":"Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada"},{"name":"Center for Addiction and Mental Health (CAMH) Campbell Family Mental Health Research Institute Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ron","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Psychiatry, Cumming School of Medicine University of Calgary Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2556-7049","authenticated-orcid":false,"given":"Maria E.","family":"Socias","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use Vancouver British Columbia Canada"},{"name":"Department of Medicine, Faculty of Medicine University of British Columbia Vancouver British Columbia Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,8,10]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"National Safety Council. 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