ORN Summer 2026 - Towards Personalized Medicine for Opioid Use Disorder: Analyses of Data from the Veterans Health Administration-2026-08-19

Video Transcription

Video Summary

The webinar featured Dr. Corey Hayes presenting two Veterans Health Administration studies on opioid use disorder (OUD) treatment and the potential for more personalized medication for opioid use disorder (MOUD) care. He explained that opioid overdose remains a major public health problem, but emphasized that overdose deaths are only the “tip of the iceberg,” and that broader outcomes like all-cause mortality can better capture the full impact of OUD treatment.<br /><br />The first study examined factors linked to early MOUD discontinuation and overdose risk. Using VA electronic health record data, Hayes found that stopping buprenorphine before 180 days was associated with much higher overdose risk, while staying on treatment reduced risk substantially. Protective factors included employment, higher VA priority status (linked to income), and living in areas with fewer racial/ethnic minority populations. Factors associated with early discontinuation included more non-psychiatric hospitalizations and Black race, suggesting system-level and social determinants likely influence retention.<br /><br />The second study assessed whether longer MOUD duration improves survival. Using an illness-death survival model, Hayes showed that staying on MOUD beyond 180 days was associated with better long-term survival for all groups studied. Benefits generally continued for years, with the largest gains in higher-risk patients, especially older men. The survival advantage appeared to level off statistically after about 2–4 years depending on age and sex, but point estimates continued to improve.<br /><br />Overall, Hayes argued that six months is likely too short for many patients and that MOUD duration should be individualized through shared decision-making, with attention to system barriers and patient risk.

Keywords

opioid use disorder

MOUD

buprenorphine

Veterans Health Administration

overdose risk

treatment discontinuation

survival analysis

shared decision-making

health disparities

personalized care