Original Investigation

Methadone vs Buprenorphine-Naloxone in Opioid Overdose Survivors

JAMA Network Open 10.1001/jamanetworkopen.2026.29313

August 25, 2026 at 11:00 AM EDT

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In this matched cohort of individuals with a past-year opioid overdose, starting methadone was associated with a reduced risk of death during the subsequent year compared with starting buprenorphine-naloxone. Treatment durations were short, particularly among individuals starting buprenorphine-naloxone, and there was no significant difference in mortality during receipt of opioid agonist treatment. These findings may be explained by unmeasured confounding, and epidemiologic studies in other jurisdictions are needed to confirm these findings.

Corresponding Author: Robert A. Kleinman, MD, MSc, Centre for Addiction and Mental Health, 100 Stokes St, 3rd Floor, Toronto, ON M6J 1H4, Canada (robert.kleinman@camh.ca).

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