Methadone vs Buprenorphine-Naloxone in Opioid Overdose Survivors

Source:

Kleinman RA, Larney S, Sule NO, Ma C, Hauck TS, Kurdyak P. Methadone vs Buprenorphine-Naloxone in Opioid Overdose Survivors. JAMA Netw Open. 2026;9(8):e2629313. doi:10.1001/jamanetworkopen.2026.29313

Key Points

Question  Among individuals with a past-year opioid overdose starting opioid agonist treatments, what is the comparative effectiveness of methadone and buprenorphine-naloxone for reducing 1-year mortality?

Findings  In this cohort study of 5882 residents from Ontario, Canada, individuals with a past-year opioid overdose starting methadone had a significantly lower hazard of death over 1 year compared with matched individuals starting buprenorphine-naloxone.

Meaning  In this study, starting methadone after an opioid overdose was associated with a reduced risk of death compared with starting buprenorphine-naloxone, a finding that requires further investigation in other jurisdictions.