After four to five years, the marginal gain from one additional year of medication for OUD was no longer significant
FRIDAY, Jan. 9, 2026 (HealthDay News) — The benefit of retention on medication for opioid use disorder (MOUD) on overall survival persists through about four to five years of treatment, according to a study published online Jan. 8 in Addiction.
Corey J. Hayes, Pharm.D., Ph.D., M.P.H., from the University of Arkansas for Medical Sciences in Little Rock, and colleagues estimated how the risk for all-cause mortality changes with the duration of MOUD in a retrospective cohort study using electronic health record data from the U.S. Veterans Healthcare Administration. The duration of MOUD was measured in days; discontinuation was defined as a gap exceeding 28 days in any MOUD coverage. The sample included 19,666 buprenorphine initiators, 8,675 methadone initiators, and 4,007 extended-release naltrexone initiators.
The researchers observed 26,841 discontinuations during approximately 226,000 person-years of time at risk for discontinuation or pre-discontinuation death (118.9 discontinuations per 1,000 person-years). There were 3,251 deaths during a total of about 106,000 person-years of post-discontinuation follow-up (3.1 deaths per 1,000 person-years). The largest marginal gain in probability of six-year survival from an additional year on MOUD occurred around two years compared with six months on MOUD. Relative to six-month MOUD retention, statistically significant gains continued through about four to five years of MOUD retention. After four to five years, there was no statistically significant marginal gain from one additional year of MOUD.
“Patients and providers will value these gains differently and our work can help guide discussions on how to optimally choose duration of therapy based on expected survival while accommodating individual values,” the authors write.
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