2026 Eastern States Conference

Authors: Brielle Liberty, PharmD; Leonard Partanna, PharmD, BCPP; Allison Pezick, PharmD, BCPP; Madeleine Morin, PharmD, BC

Learning objective: At the conclusion of my presentation, the participant will be able to compare treatment retention outcomes between methadone and buprenorphine/naloxone in patients with opioid use disorder and apply study findings to optimize medication selection and management strategies for patients with opioid use disorder.

Self Assessment Question: Why is treatment retention considered an important outcome in opioid use disorder management? A. It predicts improved blood pressure control B. It is associated with reduced relapse and overdose risk C. It eliminated the need for psychosocial support D. It guarantees abstinence from all substances

Background: 
Veterans are twice as likely to die from overdose and often medications used for opioid use disorder (OUD) are stopped soon after starting. This study aims to compare retention rates between methadone and buprenorphine/naloxone in Veterans with OUD.

Methods: This is a retrospective chart review study of veterans receiving care within a Veterans Affairs Healthcare system. Eligible patients will include Veterans 18 years and older diagnosed with opioid use disorder who initiated methadone or buprenorphine/naloxone between January 2019 and December 2024. Patients with reported prior use of medications for OUD, lacking a diagnosis of OUD, transferring care from an outside facility, or those with incomplete treatment records will be excluded. The primary outcome is to compare treatment retention rates at 1, 3, 6, and 12 months in patients initiated on methadone versus buprenorphine/naloxone. Secondary outcomes will evaluate long-term retention and reasons for discontinuing medication. Data collection will include patient demographics, comorbidities, type of medication for opioid use disorder and dose, duration of treatment, and reported reasons for discontinuation. Data will be obtained from electronic health and outpatient clinical records. Descriptive statistics will be used throughout the project.

Results: Data is in the process of being analyzed. As of now, initial data collection yielded a population of 355 veterans and more than 200 veterans were excluded based on the inclusion and exclusion criteria. Patient characteristics are significant for about 94% male population, mean age is about 60 years old, and about half the population is of black or African American race. Most commonly abused drugs are cocaine, heroin, and opioids. Full results of this study are pending.

Conclusion: This study will evaluate differences in treatment retention between methadone and buprenorphine/naloxone in a veteran population. Findings are expected to provide insight into real-world medications for OUD effectiveness and identify factors influencing treatment engagement. Results may inform targeted interventions, optimize medication selection and dosing strategies, and support improved retention among veterans with opioid use disorder.