{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T09:14:12Z","timestamp":1768036452957,"version":"3.49.0"},"reference-count":46,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T00:00:00Z","timestamp":1669248000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institute of General Medical Sciences (NIGMS) of the National Institutes of Health (NIH)","award":["U54GM115677"],"award-info":[{"award-number":["U54GM115677"]}]},{"name":"National Institute of General Medical Sciences (NIGMS) of the National Institutes of Health (NIH)","award":["P20GM125507"],"award-info":[{"award-number":["P20GM125507"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmacoepidemiology"],"abstract":"<jats:p>Opioid use disorder (OUD) is a chronic disease requiring long-term treatment and is associated with opioid overdose and increased risk of mortality. However, existing randomized clinical trials focused on short-term treatment engagement and detoxification rather than overdose or mortality risk due to limited follow-up time and ethical considerations. We used a hypothetical trial framework to conduct a retrospective cohort study to assess the effectiveness of time-varying buprenorphine-naloxone on opioid overdose and death. We identified 58,835 insured adult patients with OUD diagnosis in the US, 2010\u20132017. We fit a marginal structural model using inverse probability weighting methods to account for measured baseline and time-varying confounders, as well as selection bias due to possibly differential loss-to-follow-up. We found that receipt of buprenorphine-naloxone was associated with reduced risk of opioid overdose (hazard ratio (HR) = 0.66, 95% confidence interval (CI): 0.49, 0.91), death (HR = 0.24, 95% CI: 0.08, 0.75), and overdose or death (HR = 0.58, 95% CI: 0.40, 0.84). The E-value for death was 7.8, which was larger than the upper 95% CI of the association between each measured baseline variable and all-cause death, which implies that the unmeasured confounding itself may not explain away the estimated effect of treatment on the endpoint of all-cause mortality.<\/jats:p>","DOI":"10.3390\/pharma1030010","type":"journal-article","created":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T03:58:16Z","timestamp":1669262296000},"page":"101-112","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Evaluation of the Effectiveness of Buprenorphine-Naloxone on Opioid Overdose and Death among Insured Patients with Opioid Use Disorder in the United States"],"prefix":"10.3390","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3996-1381","authenticated-orcid":false,"given":"Tianyu","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston, RI 02881, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natallia","family":"Katenka","sequence":"additional","affiliation":[{"name":"Department of Computer Science and Statistics, College of Art and Science, University of Rhode Island, Kingston, RI 02881, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Kogut","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston, RI 02881, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2240-5768","authenticated-orcid":false,"given":"Jeffrey","family":"Bratberg","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston, RI 02881, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josiah","family":"Rich","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Brown University School of Public Health, Providence, RI 02903, USA"},{"name":"The Warren Alpert Medical School of Brown University, Providence, RI 02903, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley","family":"Buchanan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston, RI 02881, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1007\/s40122-021-00243-2","article-title":"COVID-19 and the opioid epidemic: Two public health emergencies that intersect with chronic pain","volume":"10","author":"Manchikanti","year":"2021","journal-title":"Pain Ther."},{"key":"ref_2","unstructured":"National Institute on Drug Abuse (2022, August 22). 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