Clinicians have little guidance on the ideal length of time patients with an opioid use disorder (OUD) should remain on medication for opioid use disorder (MOUD) before being able to safely discontinue it. FDA-approved MOUDs include buprenorphine, methadone, and naltrexone. Co-led by HSR investigators Corey J. Hayes, PhD, PharmD, a Career Development Awardee, and Rebecca A. Raciborski, PhD, a recent study sought to identify the point beyond which additional days of MOUD treatment did not provide significant survival benefits, while controlling for patient characteristics that could affect the risk profile independent of duration of therapy. Study participants included 19,666 Veterans using buprenorphine, 8,675 Veterans using methadone, and 4,007 Veterans using extended-release naltrexone. Veterans were middle-aged, on average, and many had chronic physical and mental health conditions (e.g. >84% chronic pain, >67% depression, >52% anxiety).
Results of this study were published in an article titled “Evaluating the Optimal Duration of Medication Treatment for Opioid Use Disorder,” which suggests that among US Veterans, the benefit of remaining on medication treatment for opioid use disorder towards overall survival (short- and medium-term) continues through at least four years of MOUD treatment. Among four age-sex groups examined, Veterans at the highest risk of death had the greatest benefit from longer therapy. Survival is not the only factor to consider in these decisions, so the decision-making process on length of MOUD treatment remains a mutual decision between the provider and the Veteran. These findings have been covered in several clinician-focused sources such as Medical XPress and Psychiatry Advisor.
Hayes C, Raciborski RA, Acharya M, et al. Evaluating the optimal duration of medication treatment for opioid use disorder. Addiction. January 7, 2026; Online ahead of print.
