{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:58:17Z","timestamp":1790708297740,"version":"4.1.0"},"reference-count":37,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"unspecified","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["PJT-156306"],"award-info":[{"award-number":["PJT-156306"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,5,9]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare the effectiveness of buprenorphine-naloxone (bup\/nal) and methadone maintenance therapy (MMT) in the treatment of patients with opioid use disorder (OUD) during the fentanyl era.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Secondary analysis of prospective cohort study data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Data for the study were collected from 54 clinical sites across Ontario, Canada, between May 2018 and January 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>To be included in the present study, participants had to be at least 16 years of age, have provided written informed consent and be receiving either MMT or bup\/nal therapy for OUD. This study includes data from 2601 participants, of whom 2068 were receiving MMT and 533 were receiving bup\/nal for OUD. The mean age of participants was 39.4 years (SD: 10.9), and 45% were female.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>MMT or bup\/nal treatment for OUD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>We employed a propensity score matched analysis to compare treatment outcomes among patients receiving MMT compared with bup\/nal. We used ongoing illicit opioid use as an indicator of treatment outcome. We considered participants with &gt;50% of urine drug screens in the past 12 months positive for non-prescribed opioids to be \u2018non-responders\u2019. We conducted subgroup analyses to identify whether treatment type was associated with ongoing non-prescribed opioid use among patients with and without a history of intravenous drug use (IVDU), and whether treatment type was associated with retention in treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eight per cent of patients on bup\/nal were considered non-responders, compared with 11.9% of patients on MMT. We did not find a statistically significant association between treatment type and treatment response. However, we did find that patients on MMT were more likely to stay in treatment for 12 months (OR 1.79, 95%\u2009CI 1.45 to 2.22, p&lt;0.001). We also found that, among patients without a history of IVDU, those on MMT were more likely to continue using non-prescribed opioids, compared with those on bup\/nal (OR 1.72, 95%\u2009CI 1.07 to 2.77, p=0.023).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among a cohort of patients with OUD receiving treatment during the fentanyl era, we find that there is no statistically significant difference in ongoing non-prescribed opioid use between patients receiving MMT compared with bup\/nal. Future studies should aim to further compare treatment effectiveness using patient-centred outcomes and pragmatic trial designs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-095645","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T06:20:33Z","timestamp":1750141233000},"page":"e095645","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Effectiveness of methadone versus buprenorphine in the treatment of opioid use disorder: secondary analyses of prospective cohort study data"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0994-1109","authenticated-orcid":false,"given":"Leen","family":"Naji","sequence":"first","affiliation":[{"name":"Family, Community & Preventative Medicine, The University of Arizona College of Medicine Phoenix, Phoenix, Arizona, USA"},{"name":"Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada"},{"name":"Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7406-4056","authenticated-orcid":false,"given":"Tea","family":"Rosic","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada"},{"name":"Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada"},{"name":"Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany","family":"Dennis","sequence":"additional","affiliation":[{"name":"Medicine, British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Worster","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Paul","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0355-9734","authenticated-orcid":false,"given":"Lehana","family":"Thabane","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada"},{"name":"Biostatistics Unit, Research Institute at St Joseph\u2019s Healthcare, Hamilton, Ontario, Canada"},{"name":"Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5974-9361","authenticated-orcid":false,"given":"Zainab","family":"Samaan","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada"},{"name":"Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada"},{"name":"Department of Psychiatry, Queen\u2019s University, Kingston, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,6,17]]},"reference":[{"key":"2025121513595922000_15.6.e095645.1","unstructured":"National Institute on Drug Abuse (NIDA) . 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