Buprenorphine Adherence May Prevent Overdose, ED Use, Hospitalization

WEDNESDAY, Dec. 3, 2025 (HealthDay News) — Buprenorphine adherence among youths may prevent overdose, emergency department use, and hospitalization, according to a study published online Nov. 18 in Pediatrics.

Scott E. Hadland, M.D., M.P.H., from Mass General Brigham for Children in Boston, and colleagues conducted a retrospective cohort analysis using 2014 to 2022 data from the Massachusetts Public Health Data Warehouse to examine patterns of duration/adherence to buprenorphine and associations with subsequent overdose, emergency department use, and hospitalization among youth aged 13 to 26 years initiating buprenorphine.

Data were included for 11,649 Massachusetts youth initiating buprenorphine (60.3 percent male; 85.9 percent non-Hispanic White; 55.4 percent enrolled in Medicaid). The researchers identified four patterns of medication use: high adherence for 12 months, low adherence for 12 months, discontinuation in three to nine months, and discontinuation in less than three months (23.7, 27.5, 16.4, and 32.5 percent, respectively). Overall, 5.0 and 6.6 percent of youth switched to methadone and naltrexone, respectively. Overdose risk was higher for lower adherence for 12 months, discontinuation in three to nine months, and discontinuation in less than three months compared with high adherence for 12 months (adjusted hazard ratios, 1.46, 1.82, and 1.76, respectively). Low adherence and discontinuation in less than three months led to a higher risk for emergency department use compared with high adherence, and a higher risk for hospitalization was seen for other trajectories compared with high adherence.

“Our findings suggest that maintaining high adherence for at least a year substantially reduces overdose risk,” Hadland said in a statement. “It”s a clear message to clinicians, families and youth that longer treatment saves lives.”

One author disclosed ties to the pharmaceutical industry.

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