{"doi":"10.5811/westjem.18569","title":"Buprenorphine-Naloxone for Opioid Use Disorder: Reduction in Mortality and Increased Remission","abstract":"Introduction: As fentanyl has become more readily available, opioid-related morbidity and mortality in the United States has increased dramatically. Preliminary studies suggest that high-affinity, partial mu-opioid receptor agonists such as the combination product buprenorphine-naloxone may reduce mortality from overdose and promote remission. With the escalating prevalence of opioid use disorder (OUD), it is essential to evaluate the effectiveness of opioid agonists like buprenorphine-naloxone. This study examines mortality and remission rates for OUD patients prescribed buprenorphine-naloxone to determine the efficacy of this treatment toward these outcomes. Methods: We carried out a retrospective analysis using the US Collaborative Network database in TriNetX, examining de-identified medical records from nearly 92 million patients across 56 healthcare organizations. The study spanned the years from January 1, 2017–May 13, 2022. Cohort 1 included OUD patients who began buprenorphine-naloxone treatment within one-year post-diagnosis, while Cohort 2, the control group, consisted of OUD patients who were not administered buprenorphine. The study measured mortality and remission rates within a year of the index event, incorporating propensity score matching for age, gender, and race/ethnicity. Results: Prior to propensity matching, we identified a total of 221,967 patients with OUD. Following exclusions, 61,656 patients treated with buprenorphine-naloxone showed 34% fewer deaths within one year of diagnosis compared to 159,061 patients who did not receive buprenorphine (2.6% vs 4.0%; relative risk [RR] 0.661; 95% confidence interval [CI] 0.627–0.698; P < 0.001). The remission rate was approximately 1.9 times higher in the buprenorphine-naloxone group compared to the control group (18.8% vs 10.1%; RR 1.862; 95% CI 1.812–1.914; P < 0.001). After propensity matching, the effect on mortality decreased but remained statistically significant (2.6% vs 3.0%; RR 0.868; 95% CI 0.813–0.927; P < 0.001) and the remission rate remained consistent (18.8% vs 10.4%; RR 1.812; 95% CI 1.750–1.876; P < 0.001). Number needed to treat for benefit was 249 for death and 12 for remission. Conclusion: Buprenorphine-naloxone was associated with significantly reduced mortality and increased remission rates for patients with opioid use disorder and should be used as a primary treatment. The recognition and implementation of treatment options like buprenorphine-naloxone is vital in alleviating the impact of OUD.","journal":"Western Journal of Emergency Medicine","year":2024,"id":462754,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9529,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1293081,"name":"Christian G Frey","orcid":null,"position":1,"is_corresponding":false},{"id":1293082,"name":"Stanley Troung","orcid":null,"position":2,"is_corresponding":false},{"id":1293083,"name":"Laura Vita Q Paglicawan","orcid":null,"position":3,"is_corresponding":false},{"id":435499,"name":"Kathryn A. Cunningham","orcid":"0000-0002-4257-1739","position":4,"is_corresponding":false},{"id":1037245,"name":"Timothy Hill","orcid":"0009-0009-8942-5091","position":5,"is_corresponding":false},{"id":1292592,"name":"Lauren G Bothwell","orcid":"0009-0003-2665-9129","position":6,"is_corresponding":false},{"id":1293084,"name":"Georgiy Golovko","orcid":null,"position":7,"is_corresponding":false},{"id":1293085,"name":"Yeoshina Pillay","orcid":null,"position":8,"is_corresponding":false},{"id":1037247,"name":"Dietrich Jehle","orcid":"0000-0003-3056-7481","position":9,"is_corresponding":false},{"id":1037246,"name":"Krishna K Paul","orcid":"0000-0002-9829-1250","position":0,"is_corresponding":true}],"reference_count":1,"raw_metadata":null,"created_at":"2026-07-19T02:04:24.680035Z","pmid":"39625756","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}