Thread by @MyHarmReduction

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NEW STUDY:

The rate of all-cause mortality for people on Opioid Agonist Treatment (buprenorphine or methadone) was 53% LOWER than the rate when people were not on these medications. (1/x)

jamanetwork.com/journals/jamap…

“This association was consistent regardless of patient sex, age, geographic location, HIV status, and hepatitis C virus status and whether drugs were taken through injection."

AND

“Associations were not different for methadone vs buprenorphine” (2/x)

The researchers found there was:
➡️52% lower risk of suicide,
➡️28% lower risk of cancer,
➡️59% lower drug-related,
➡️41% lower alcohol-related , and
➡️ 31% lower cardiovascular-related mortality during treatment with buprenorphine or methadone. (3/x)

Important note: “In the first 4 weeks of methadone treatment, rates of all-cause mortality and drug-related poisoning were almost double the rates during the remainder of OAT but not for buprenorphine" (first 4 weeks associated with 42% less likelihood of any cause death). (4/x)

The above information should be noted insofar as patients need to receive support and education to reduce risk during early days of methadone. It is not reason to avoid methadone treatment or to say it 'doesn't work' bc it does the longer you're on it. (5/x)

“All-cause mortality was 6 times higher in the 4 weeks after OAT cessation, remaining double the rate for the remainder of time not receiving OAT.”

Currently our jails/prisons force people off these medications, increasing mortality risk.
(6/x)

Many of us already knew this, but this study is the first of its kind to pull together all research on OAT and mortality due to a number of causes and synthesize the findings together.

TL; DR- Buprenorphine and methadone save lives. #XtheXwaiver and #FreeMethadone. (7/x)

Many of you in the US might wonder why this study uses "OAT" vs. "MAT." This is done to include methadone and buprenorphine while excluding naltrexone.

➡️Methadone is an opioid agonist.
➡️Buprenorphine is a partial opioid agonist.
➡️Naltrexone is an opioid antagonist. (8/x)

Naltrexone is rarely used as a medication to treat Opioid Use Disorder globally, but it holds a very special place in the hearts of folks in the US - particularly those in the criminal legal system, our abstinence-only settings, etc. (9/x)

Globally, there is clearer consensus that Opioid Use Disorder treatment with opioid agonists or substitutes is actually the best approach with folks currently using unregulated street opioids.

You may find folks using "OAT" or "OST" - Opioid Substitution Treatment abroad. 10/x

Thanks for reading! Done now!