Observational studyAddiction (Abingdon, England)2024
Comparative effectiveness of extended-release naltrexone and sublingual buprenorphine for treatment of opioid use disorder among Medicaid patients.
Observational study in Addiction (Abingdon, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed.
- Beneficial effects of the rapid vs. standard procedure for injection naltrexone initiation operate through increased adjunctive medication use.Drug and alcohol dependence · 2026Trial
- Comparative effectiveness of extended-release naltrexone versus buprenorphine-naloxone on treatment interruption: Comparing findings from a reanalysis of the X:BOT RCT and harmonized target trial emulation using population-based observational data.Addiction (Abingdon, England) · 2025Trial
- Buprenorphine-Naloxone vs Extended-Release Naltrexone Following Opioid Withdrawal Treatment.JAMA network open · 2026Observational
- Impact of study design decisions on identification of treatment initiators of medications for opioid use disorder.Addiction (Abingdon, England) · 2026Article
- Pharmacotherapy and overdose risk following new opioid use disorder diagnosis among Medicaid beneficiaries.The American journal of drug and alcohol abuse · 2026Article
- Identifying Extended-Release Naltrexone Treatment for Opioid Use Disorder in US Medicaid Data.Pharmacoepidemiology and drug safety · 2026Article
- Receipt of Buprenorphine and Naltrexone for Opioid Use Disorder by Race and Ethnicity and Insurance Type.JAMA network open · 2025Article
- Sex disparities in outcome of medication-assisted therapy of opioid use disorder: Nationally representative outpatient clinic data.Drug and alcohol dependence · 2025Observational
- Opioid Use Disorder in Older Adults: a Narrative Review.Current geriatrics reports · 2025Article
- Sex disparities in outcome of medication-assisted therapy of opioid use disorder: Nationally representative study.medRxiv : the preprint server for health sciences · 2024Article
Corrections and comments
- Update of
Authors and funding
7 authors.
Funding
Abstract
BACKGROUND AND
aimsExtended-release naltrexone (XR-NTX) and sublingual buprenorphine (SL-BUP) are both approved for opioid use disorder (OUD) treatment in any medical setting. We aimed to compare the real-world effectiveness of XR-NTX and SL-BUP. DESIGN AND
settingThis was an observational active comparator, new user cohort study of Medicaid claims records for patients in New Jersey and California, USA, 2016-19. PARTICIPANTS/CASES: The participants were adult Medicaid patients aged 18-64 years who initiated XR-NTX or SL-BUP for maintenance treatment of OUD and did not use medications for OUD in the 90 days before initiation. Our cohort included 1755 XR-NTX and 9886 SL-BUP patients. MEASUREMENTS: We examined two outcomes up to 180 days after medication initiation: (1) composite of medication discontinuation and death and (2) composite of overdose and death.
findingsIn adjusted analyses, treatment with XR-NTX was more likely to result in discontinuation or death by the end of follow-up than treatment with SL-BUP: cumulative risk 75.9% [95% confidence interval (CI) = 73.9%, 77.9%] versus 62.2% (95% CI = 61.2%, 63.2%), respectively (risk difference = 13.7 percentage points, 95% CI = 11.4, 16.0). There was minimal difference in the cumulative risk of overdose or death by the end of follow-up: XR-NTX 3.9% (95% CI = 3.0%, 4.8%) versus SL-BUP 3.3% (95% CI = 2.9%, 3.7%); risk difference = 0.5 percentage points, 95% CI = -0.4, 1.5. Results were consistent across sensitivity analyses.
conclusionsMedicaid patients in California and New Jersey, USA, receiving treatment for opioid use disorder stayed in treatment longer on sublingual buprenorphine than on extended-release naltrexone, but the risk of overdose was similar. Most patients in this study discontinued medication within 6 months, regardless of which medication was initiated.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.